Background. Growing evidence shows cannabis use is associated with lower rates of metabolic dysregulation. Despite cannabis impacting each sex differently, few studies have examined the metabolic profile of male and female cannabis users separately. Our aim was to investigate whether cannabis use is associated with metabolic syndrome and its components in men and women with psychotic illness.
Method. The second Australian psychosis survey used a two-phase design to randomly select a nationally representative sample of adults with psychotic illness for interview and physical assessment. A total of 1078 men and 735 women provided data on cannabis use. Multiple logistic regression was used to model, separated for each sex, the influence of no, occasional and frequent past-year cannabis use on metabolic syndrome, adjusting for potential covariates including antipsychotic medication, smoking, alcohol and physical activity.
Results. In the past-year, 179 women and 419 men had used cannabis. The proportion of each sex with metabolic syndrome was 58.1% and 57.6% respectively. Unadjusted analyses showed frequent cannabis use was associated with significantly lower odds of metabolic syndrome for both sexes. In weighted adjusted analyses, the association between metabolic syndrome and frequent cannabis use remained significant for men (OR =0.49, 95% CI=0.31-0.78), but not for women (OR=0.68 95% CI=0.37-1.24). Frequent cannabis use was associated with smaller waist circumference, lower blood pressure and lower triglyceride levels in men but not women.
Conclusions. Our data indicate that, for men only, regular cannabis use may have cardiometabolic protective effects, suggesting cannabinoid regulation of energy balance may be sex-dependent.