Bengü BAZ YÜCENS, Vahap Ozan KOTAN, Zeynep KOTAN, GÜVEN ÖZKAYA, İHSAN TUNCER OKAY, Baise TIKIR, EROL GÖKA

Differences in sociodemographic characteristics, clinical features and serum liver function tests of male cannabis and synthetic cannabinoid users

Amaç: Sentetik kannabinoidler (SK), ciddi zararlı klinik etkileriyle, önemli bir madde kullanım sorunu haline gelmiştir. Özellikle kannabis (K) kullanan genç erkekler, SK kullanma riskine sahiptir. Bu çalışmanın amacı SK kullanıcılarının sosyodemografik özellikleri, klinik özellikleri ve serum karaciğer işlev testlerinin araştırılması ve bu verilerin K kullanıcılarınınkilerle karşılaştırılmasıdır. Yöntem: Ankara Numune Eğitim ve Araştırma Hastanesi AMATEM Polikliniği'nde değerlendirilen 118 SK kullanıcısı arasından 74 erkek hastanın katıldığı kesitsel bir çalışmadır. K ve SK dışında madde veya ilaç kullanımı olan ve serum karaciğer işlev testlerini etkileyebilecek herhangi bir fiziksel hastalığı olan hastalar çalışma dışı tutulmuştur. Yetmiş dört hastanın %44.6'sı (s=33) son üç aydır yalnız SK kullanmaktayken, %55.4'ü (s=41) K ve SK aynı anda kullanmaktaydı. Kontrol grubunu yaş ve beden kitle indeksi açısından eşleştirilmiş 34 yalnız K kullanıcısı erkek oluşturdu. Bulgular: K kullanıcılarında eş-çocukla, anne-babayla birlikte yaşama oranı SK kullanıcılarından daha yüksek, SK kullanıcılarında ise arkadaşlarıyla yaşama ve yalnız yaşama oranı K kullanıcılarından daha yüksek saptandı. Advers etkiler ve kesilme belirtileri K ve SK kullanıcılarında benzerdi. Serum karaciğer işlev testleri karşılaştırıldığında gama-glutamil transpeptidaz, alkalin fosfataz, total/ direkt bilirubin, albumin, protrombin zamanı ve INR (International Normalized Ratio) düzeyleri benzerdi. Kannabis kullanıcıları ile K ve SK kullanıcıları arasında serum aspartat aminotransferaz düzeyleri (sırasıyla 31.2±22.0 IU/L ve 41.5±21.5 IU/L, p=0.026) ve serum alanin aminotransferaz düzeyleri (sırasıyla 28.4±18.9 IU/L and 44.3±25.9 IU/L, p=0.015) anlamlı olarak farklı saptandı. Çalışmamızın sonuçları serum aminotransferaz düzeylerindeki artışın özellikle kombine K ile SK kullanıcılarında olduğunu gösterdi. Sonuçlar: K kullanımı SK kullanımı için bir öncü olabilir ve arkadaşlarıyla veya yalnız yaşayan K kullanıcıları için SK kullanımı riski daha fazlayken, aileyle yaşama koruyucu bir etken olabilir. K ev SK kombine kullanımının hepatoselüler hasara yol açma riski, K veya SK tek başına kullanımından daha yüksek görünmektedir.

Kannabis ve sentetik kannabinoid kullanan erkeklerde sosyodemografik özellikler, klinik özellikler ve serum karaciğer işlev testleri

Objective: Synthetic cannabinoid (SC) use has recently become a growing substance abuse problem, with serious harmful clinical effects. Young males, especially cannabis (C) users, are at great risk of SC use. The aim of this study is to determine sociodemographic characteristics, clinical features and serum liver function tests of SC users and compare with those of C users. Methods: Out of 118 SC users applied to outpatient clinic of Ankara Numune Training and Research Hospital Alcohol and Substance Addiction Treatment Center, 74 males included in this cross-sectional study. Patients with a concurrent use of any medication or substance other than C/SCs or patients with any physical illness which could affect serum liver function tests were excluded. 44.6% (n=33) of 74 patients were only SC users at least for last three months and 55.4% (n=41) were combined C and SC (C&SC) users. SC users were compared with 34 age and BMI-matched only C using males. Results: Rates of being single and divorced; rates of living with friends and alone were found to be higher in SC users. Adverse effects and withdrawal sypmtoms were found to be similar in C users and SC users. According to serum liver function test results, levels of gama-glutamil transpeptidase, alkaline phosphatase, total/direct bilirubin, albumin, prothrombin time and international normalized ratio were similar. Serum aspartate aminotransferase levels (31.2±22.0 IU/L and 41.5±21.5 IU/L respectively, p=0.026) and serum alanine aminotransferase levels (28.4±18.9 IU/L and 44.3±25.9 IU/L respectively, p=0.015) differed between C users and C&SC users. Results in this study revealed that increased serum levels of aminotransferases were especially associated with combined use of C and SCs. Conclusions: C abuse seems to be a precursor of SCs abuse, and risk of starting SCs use could be bigger for C users, who live alone or with friends, whereas living together with a family could be preventative. Combined use of C and SCs seem to increase the risk of hepatocellular injury compared to either C or SCs alone.

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