Characteristics Of Dietary Patterns And Dietary Inflammatory Index And Their Effects On Glucose Metabolism In Cannabis Users

Objective To investigate the characteristics of dietary patterns and dietary inflammatory index of cannabis users in the United States and their effects on glucose metabolism,so as to provide reference for conducting nutrition studies on special populations and preventing glucose metabolism disorders.MethodsThe demographic data,dietary surveys,physical and laboratory biochemical examinations,and questionnaire information of cannabis users and the control group who met the inclusion criteria in the data given in the NHANES 2005~2018 database were extracted and summarized.Dietary intakes of various foods and nutrients were calculated,and nutrient satisfaction levels were evaluated,the dietary patterns of different groups were summarized using principal component analysis,and Energy-adjusted dietary inflammation index(EDII)was calculated;multiple logistic regression was used to analyze the association between dietary pattern,EDII quartile groups and outcome of glucose metabolism disorders;generalized linear regression was used to analyze the association between EDII and each physical and biochemical index,and bivariate response surface model was used to demonstrate the interaction effect of two continuous variables on a single index of interest.Results1.20,641 people were included in this study,including 5014 people in the normal glucose metabolism group,3269 people in the prediabetes(pre DM)group,and 1171 people in the Diabetes Mellitus(DM)group among non-cannabis users;6563 people in the normal glucose metabolism group,3629 people in the pre DM group,and 995 people in the DM group among cannabis users.2.The dietary patterns of cannabis users and non-users were extracted using principal component analysis,and three dietary patterns were extracted for cannabis users,including the "milk-bean-grain-fruit" pattern(17.539%),"vegetable-fat" pattern(12.801%),and "meat-sugar" pattern(11.772%),with a 42.112% cumulative contribution rate;the non-cannabis users included "milk-bean-grain-fruit"(16.915%),"vegetable-fat"(13.552%)and "meat-egg-sugar"(11.674%),with a 42.226%cumulative contribution rate.Six dietary patterns and inadequate intake of dietary fiber,C18:2,magnesium,potassium,fat-soluble vitamins,and excess of the energy supply ratio of edible sugars were present in both male and female populations in both categories.Dietary patterns had different effects on physical and biochemical indicators and glucose metabolism disorder outcomes.Among cannabis non-users,the "milk-bean-grain-fruit" pattern was a protective factor for DM(OR=0.807,95%CI:0.686~0.950);while in cannabis users,the "milk-bean-grain-fruit" pattern was both protective factor for pre DM(OR=0.881,95%CI:0.796~0.975)and DM(OR=0.740,95%CI:0.626~0.860).3.The maximum EDII value of subjects was 2.33 and the minimum value was-7.62;the distribution of EDII quartile was statistically different(P<0.05)in terms of demographic characteristics in both cannabis users and non-users and statistically different(P<0.05)in the groups with different glucose metabolism status in cannabis-users.EDII had different effects on physical and biochemical indicators and glucose metabolism disorder outcomes in cannabis users and non-users.Among cannabis users,the OR of EDII was 1.073(95% CI:1.045~1.101)for pre DM and 1.043(95%CI:1.000~1.088)for DM.4.The different glucose metabolic status of cannabis users and non-users were grouped together and found that there were statistical differences in the levels of some physical and biochemical indicators between the different groups(P<0.05).Overall,cannabis using was a protective factor for pre DM(OR=0.848,95%CI:0.799~0.900)and DM(OR=0.649,95%CI:0.592~0.712),but using cannabis regularly was a risk factor for pre DM(OR=1.169,95%CI:1.074~1.272).5.The interaction of regular cannabis using with EDII Q2 demonstrated a protective effect on DM(OR=0.180,95% CI:0.038,0.863);the interaction of year of first cannabis using from the time the survey was conducted combined with EDII was negatively associated with fasting blood glucose(FPG)level,insulin(INS)level,and subscapular skinfold thickness(P<0.05).The interaction of the first year using cannabis from the time of the survey with EDII was negatively associated with INS levels(P<0.05)and positively associated with aspartate aminotransferase(AST)and phosphocreatine kinase(CPK)levels(P<0.05).The interaction of the year of last cannabis use from the time of the survey with EDII was positively associated with body mass index(BMI),upper arm circumference,and systolic blood pressure(SBP)(P<0.05).The interaction of the number of days of cannabis use in the 30 days before the survey and EDII was negatively associated with FPG(P<0.05)and positively associated with CPK(P<0.05).Conclusions1.The dietary patterns of both cannabis users and non-users were extracted using principal component analysis,and three dietary patterns were extracted for cannabis users,including the "milk-bean-grain-fruit" pattern,the "vegetable-fat" pattern,and the "meat-sugar" pattern.The cannabis users included "milk-bean-grain-fruit","vegetable-fat",and "meat-egg-sugar" patterns;the cannabis non-users included "milk-bean-grain-fruit","vegetable-fat",and "meat-egg-sugar" patterns.Among marijuana users with DM,the largest number of patients had the "meat-sugar" pattern;among non-marijuana users,the largest number had the "meat-egg-sugar" pattern.2.The maximum value of EDII was 2.33 and the minimum value was-7.62.In the pre DM group,the quartile of dietary inflammation increased gradually from Q1 to Q4 and was statistically significant in cannabis users;no significant difference was found in the DM group.3.The dietary pattern had different effects on physical and biochemical indices,and the "milk-bean-grain-fruit" pattern was a protective factor for pre DM and DM regardless of cannabis smoking;the "vegetable-fat" pattern was a protective factor for DM in cannabis users.The "vegetable-fat" model was the protective factor for DM in cannabis users.4.EDII has different effects on physical and biochemical indicators,and the risk of pre DM and DM increases with the increase of EDII regardless of cannabis use.5.The interaction between frequency of cannabis smoking and EDII was mainly associated with glucose/fat/protein metabolism,liver and kidney function,and body measure indicators.The interaction of the year of initial cannabis use with EDII was negatively correlated with FPG,INS,and subscapular fold thickness.The interaction of the year of initiation of regular cannabis use with EDII was negatively correlated with INS level and positively correlated with AST and CPK level.The interaction of the year of last cannabis use with EDII was positively correlated with BMI,upper arm circumference,and SBP.The interaction of the year of last cannabis use from the time of the survey combined with EDII was positively correlated with BMI,upper arm circumference,and SBP.The interaction of the number of days of cannabis use in the30 days before the survey combined with EDII was negatively correlated with FPG and positively correlated with CPK.