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PLoS One. 2017 Apr 25;12(4):e0176416. doi: 10.1371/journal.pone.0176416. eCollection 2017.

Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study.

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Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
Biomedical Engineering & Biotechnology Program, University of Massachusetts Lowell, Lowell Massachusetts, United States of America.
Department of Medicine, Maimonides Medical Center, Brooklyn, New York, United States of America.
Johns Hopkins Medicine, Howard County General Hospital, Columbia, Maryland, United States of America.
Public Health Program, University of Massachusetts Lowell, Lowell, United States of America.
Department of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey, United States of America.
Department of Pediatrics, Bronx-Lebanon Hospital Center, Bronx, New York, United States of America.
Department of Maternal and Child Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
INRS-Institut Armand-Frappier, Institut National de la Reserche Scientifique, Laval, Quebec, Canada.


Cannabis use is associated with reduced prevalence of obesity and diabetes mellitus (DM) in humans and mouse disease models. Obesity and DM are a well-established independent risk factor for non-alcoholic fatty liver disease (NAFLD), the most prevalent liver disease globally. The effects of cannabis use on NAFLD prevalence in humans remains ill-defined. Our objective is to determine the relationship between cannabis use and the prevalence of NAFLD in humans. We conducted a population-based case-control study of 5,950,391 patients using the 2014 Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Survey (NIS) discharge records of patients 18 years and older. After identifying patients with NAFLD (1% of all patients), we next identified three exposure groups: non-cannabis users (98.04%), non-dependent cannabis users (1.74%), and dependent cannabis users (0.22%). We adjusted for potential demographics and patient related confounders and used multivariate logistic regression (SAS 9.4) to determine the odds of developing NAFLD with respects to cannabis use. Our findings revealed that cannabis users (dependent and non-dependent) showed significantly lower NAFLD prevalence compared to non-users (AOR: 0.82[0.76-0.88]; p<0.0001). The prevalence of NAFLD was 15% lower in non-dependent users (AOR: 0.85[0.79-0.92]; p<0.0001) and 52% lower in dependent users (AOR: 0.49[0.36-0.65]; p<0.0001). Among cannabis users, dependent patients had 43% significantly lower prevalence of NAFLD compared to non-dependent patients (AOR: 0.57[0.42-0.77]; p<0.0001). Our observations suggest that cannabis use is associated with lower prevalence of NAFLD in patients. These novel findings suggest additional molecular mechanistic studies to explore the potential role of cannabis use in NAFLD development.

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