P4680 - Cannabis Use in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Friend or a Foe? Insights From a Nationwide Analysis (2016-2020)

Ruchir Damjibhai. Paladiya, MBBS¹, Anmol Singh, MBBS², Mihir P. Shah, MD³, Vikash Kumar, MD⁴, Aalam Sohal, MD⁵, Shreyans Doshi, MD⁶, Neil D.. Parikh, MD^7
1University of Connecticut Health Center, Hartford, CT; ²Tristar Centennial Medical Center, Nashville, TN; ³John H. Stroger, Jr. Hospital of Cook County, Cook County, IL; ⁴Creighton University School of Medicine, Brooklyn, NY; ⁵Creighton University School of Medicine, Seattle, WA; ⁶Wake Forest University School of Medicine, Charlotte, NC; ⁷Hartford Hospital, Harford, CT

Introduction: Cannabis use (CU) has exploded since its legalization, and currently, we are trying to assess the impact of its use on various chronic conditions. Metabolic dysfunction-associated steatotic liver disease (MASLD) has been on the rise worldwide, leading to hepatic steatosis, inflammation, and damage that can progress to fibrosis, cirrhosis, or even cancer. The literature has supported cannabidiol’s anti-inflammatory and anti-fibrotic effects on various liver diseases through in vivo and in vitro models. This study explores the role of CU on the outcomes of hospitalized MASLD patients.

Methods: The National Inpatient Sample (NIS) 2016–2020 was used to identify adult patients (age > 18 years) with MASLD using ICD-10 codes. Patients with missing demographics and mortality data were excluded from the study. Patients were stratified into two groups based on the prevalence of cannabis use. Data were collected on patient demographics, Elixhauser Comorbidity Index (ECI), and comorbidities. A multivariate logistic regression analysis was performed to evaluate the impact of CU on these outcomes.

Results: Of the 3,379,484 patients, CU was identified in 52,315 (1.54%) patients. The majority of the CU patients were aged 18-44 years (46.4%), male (59.7%) and white race (59.75). Table 1 shows the prevalence of CU among various comorbidities. Patients with CU had a lower prevalence of cirrhosis (21.8% vs 36.8%, p< 0.001), decompensated cirrhosis (DC) (11.9% vs 21.2%, p< 0.001), hepatocellular cancer (HCC) (0.8% vs 1.7%, p< 0.001), chronic kidney disease (CKD) (13% vs 24.3%, p< 0.001), heart failure (HF) (14.7% vs 22.5%,p< 0.001), and in-hospital mortality (IHM) (2.2% vs 4.5%, p< 0.001). (Figure 1) After adjusting for confounding factors, patients with CU had lower odds of IHM (aOR- 0.70, 95% CI-0.61-0.80, p< 0.001), cirrhosis (aOR- 0.72, 95% CI-0.68-0.76, p< 0.001), DC (aOR-0.73, 95% CI-0.68-0.78, p< 0.001), CKD (aOR-0.81, 95% CI-0.76-0.86, p< 0.001) and HCC (aOR-0.71, 95% CI 0.57-0.89, p=0.003), however had higher odds of myocardial infarction (MI) (aOR-1.42, 95% CI-1.27-1.83, p< 0.001) and stroke (aOR-1.53, 95% CI-1.27-1.83, p< 0.001).

Discussion: Our study highlights that patients with MASLD are associated with lower risk of developing liver related events but higher risk of myocardial infarction and stroke with concomitant CU. Clinical trials involving CBD and monitoring its effects are limited and further research would be valuable to elucidate more mechanisms in regards to these novel findings.



Disclosures:


Ruchir Damjibhai. Paladiya, MBBS¹, Anmol Singh, MBBS², Mihir P. Shah, MD³, Vikash Kumar, MD⁴, Aalam Sohal, MD⁵, Shreyans Doshi, MD⁶, Neil D.. Parikh, MD⁷. P4680 - Cannabis Use in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Friend or a Foe? Insights From a Nationwide Analysis (2016-2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.