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Exploring the Anti-inflammatory Properties of Cannabis and Their Relevance to Insulin Sensitivity

Completed
Conditions
Insulin Sensitivity
Type 2 Diabetes
Obesity
Cannabis Use
Registration Number
NCT04114903
Lead Sponsor
University of Colorado, Boulder
Brief Summary

This study tests the effects of cannabinoid levels in blood on inflammation and insulin sensitivity both acutely and chronically in individuals across the weight spectrum. To that end, the study employs two observational designs: 1) A study of acute effects with intermittent cannabis users and 2) A study in which current cannabis users will select one of three cannabis strains for four weeks and are compared to a matched control group who do not use cannabis to study chronic effects. Blood levels of THC and CBD, inflammatory biomarkers, and insulin resistance will be measured in both studies.

Detailed Description

According to the National Institute of Diabetes and Digestive and Kidney Diseases, over 30 million people in the US have diabetes, and just over 84 million people have pre-diabetes. Concurrently, 30 states and the District of Columbia have legalized cannabis for medical and/or recreational use and over the past decade, cannabis use among adults has more than doubled.

Public perception and some scientific data suggest that cannabis causes acute over-eating, creating concern that public and legal acceptance of cannabis use will worsen the obesity epidemic in the United States, where more than two-thirds of US adults (68.8%) are currently overweight or obese. Paradoxically, cross sectional data demonstrate associations between chronic cannabis use and lower body mass index (BMI), prevalence of obesity, insulin resistance, waist circumference, and actual rates of type 2 diabetes despite data supporting higher caloric intake acutely.

This study examines the effects of cannabinoid levels in blood on inflammation and insulin sensitivity both acutely and chronically in individuals across the weight spectrum. To that end, the study employs two observational designs: 1) A study of acute effects with intermittent cannabis users and 2) A study in which current cannabis users will select one of three cannabis strains for four weeks and are compared to a matched control group who do not use cannabis to study chronic effects.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
255
Inclusion Criteria
  • Able to provide informed consent
  • Cannabis users in Study A must have smoked or vaped cannabis at least once since January 1st 2014 with no negative effects but NOT used in the past three months
  • Cannabis users in Study B must have been a regular (at least weekly) user for at least a year
  • Non-users in Study B cannot have used any cannabis in the previous year
  • Weight stable (<5 pound fluctuation in the past six months)
  • Planning to remain in the Boulder-Denver area for the next month
  • Fasting blood glucose greater than or equal to 55 mg/dl and less than or equal to 126 mg/dl
  • Cannabis users in Study A must endorse knowledge of the procedure(s) for smoking or vaping cannabis
Exclusion Criteria
  • Known auto-immune disease
  • Report of other drug use (cocaine, opiates, methamphetamine) in the past 90 days or fail urine screen for any of these drugs
  • Daily tobacco (cigarette, E-cigs, smokeless) user, given the impact of tobacco smoking on insulin function
  • Blood alcohol level greater than 0 at screening
  • Current use of medications for glucose lowering, immunosuppression, or anti-inflammation
  • Acute illness
  • Current use of psychotropic medications
  • Current diagnosis of diabetes
  • Heavy drinking as defined by an Alcohol Use Disorders Test (AUDIT)
  • Females can not be pregnant or trying to become pregnant
  • Females can not be nursing mothers
  • Have donated blood in the 8 weeks before the study or intend to donate blood in the 8 weeks after the study.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Markers of InflammationStudy A: Difference between cytokines at baseline and cytokines one week later after acute use of cannabis product. Study B: Change from baseline to four weeks

Change in Circulating Levels of Cytokines (TNF-α, IL-1B, IL-4, IL-6, IL-10, IL-13, MCP-1)

Change in Plasma GlucoseStudy A: Baseline versus one week later after acute use of cannabis product. Study B: The two tests will be separated by four weeks

Change in glucose over time after ingestion of 75 grams oral glucose measured during during oral glucose tolerance test (OGTT). Measurements are collected on venous blood samples at 0, 30, 60, 90, and 120 minutes.

Change in Matsuda Index of Insulin SensitivityStudy A: Baseline versus after acute use one week later of cannabis product. Study B: The two tests will be separated by four weeks

Calculation of Insulin Sensitivity using changes in fasting plasma glucose (FPG) and fasting plasma insulin (FPI).

Measurements are collected on venous blood samples at 0, 30, 60, 90, and 120 minutes after ingestion of 75 grams oral glucose during oral glucose tolerance test (OGTT)

Matsuda Index is calculated as follows: 10000/sqrt ((FPG X FPI) X (Mean OGTT glucose concentration X Mean OGTT insulin concentration))

Change in Plasma InsulinStudy A: Baseline versus one week later after acute use of cannabis product. Study B: The two tests will be separated by four weeks

Change in insulin over time after ingestion of 75 grams oral glucose measured during OGTT. Measurements are collected on venous blood samples at 0, 30, 60, 90, and 120 minutes.

Secondary Outcome Measures
NameTimeMethod
The Alcohol Use Disorder Identification Test (AUDIT)Study A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Standardized assessment of the extent of alcohol use and problems related to alcohol use

Stanford Seven-Day Physical Activity Recall (PAR)Study A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Interviewer administered assessment of number of minutes of mild, moderate, and vigorous physical activity over the previous seven days.

Sleep QualityStudy A: Baseline to one week following baseline Study B: Baseline to four weeks following baseline

Pittsburgh Sleep Quality Index: Measurement of the quality and patterns of sleep from poor to good measuring seven domains (e.g., latency, duration, disturbances) over the last 2 weeks.

Marijuana Consumption QuestionnaireStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Frequency and quantity of cannabis use, age of first use, peer use, perceived risk from cannabis, and perceived availability of cannabis

Marijuana Dependence ScaleStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Based on DSM V criteria that were converted to a self-report to assess dependence and other problems related to the use of cannabis

Marijuana Withdrawal ChecklistStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

A 15-item scale used to collect information on withdrawal symptoms participants may be experiencing due to lack of use of marijuana

Timeline Follow-Back of Substance UseStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Calendar-based assessment of daily substance use for the 30 days prior to the baseline session only for both studies

SF-12 Health SurveyStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

The SF-12 Health Survey is a 12-item questionnaire used to assess general health and well-being and includes domains of physical functioning, role-physical, pain, general health, vitality, social functioning, role-emotional and mental health

Nutrition Data System for Research 24-Hour Dietary RecallStudy A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Interviewer administered recall measure developed by the University of Minnesota Nutrition Coordinating Center (NCC), that facilitates the standardized collection of 24-hour dietary recall data

Stanford Leisure-Time Activity Categorical Item (L-Cat)Study A: Baseline and one week following baseline Study B: Baseline and four weeks following baseline

Self-report measure of a single item comprising six descriptive categories ranging from inactive to very active

Trial Locations

Locations (1)

Center for Innovation and Creativity

🇺🇸

Boulder, Colorado, United States

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