Cannabinoid system is a crucial mechanism in regulating food intake and energy metabolism. It is involved in central and peripheral mechanisms regulating such behavior, interacting with many other signaling systems with a role in metabolic regulation. Cannabinoid agonists promote food intake, and soon a cannabinoid antagonist, rimonabant, will be marketed for the treatment of obesity. It not only causes weight loss, but also alleviates metabolic syndrome. We present a review of current knowledge on this subject, along with data from our own research: genetic studies on this system in eating disorders and obesity and studies locating cannabinoid receptors in areas related to food intake. Such studies suggest cannabinoid hyperactivity in obesity, and this excessive activity may have prognostic implications.
Patients with an alcohol abuse disorder exhibit several medical characteristics and social determinants, which suggest a greater vulnerability to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a worse course of the coronavirus disease 2019 (COVID-19) once infected. During the first wave of the COVID-19, most of the countries have register an increase in alcohol consumption. However, studies on the impact of alcohol addiction on the risk of COVID-19 infection are very scarce and inconclusive. This research offers a descriptive observational retrospective cohort study using real world data obtained from the Electronic Health Records. We found that patients with a personal history of alcohol abuse were 8% more likely to extend their hospitalization length of stay for 1 day (95% CI = 1.04–1.12) and 15% more likely to extend their Intensive Care Unit (ICU) length of stay (95% CI = 1.01–1.30). They were also 5.47 times more at risk of needing an ICU admission (95% CI = 1.61–18.57) and 3.54 times (95% CI = 1.51–8.30) more at risk of needing a respirator. Regarding COVID-19 symptoms, patients with a personal history of alcohol abuse were 91% more likely of exhibiting dyspnea (95% CI = 1.03–3.55) and 3.15 times more at risk of showing at least one neuropsychiatric symptom (95% CI = 1.61–6.17). In addition, they showed statistically significant differences in the number of neuropsychiatric symptoms developed during the COVID-19 infection. Therefore, we strongly recommend to warn of the negative consequences of alcohol abuse over COVID-19 complications. For this purpose. Clinicians should systematically assess history of alcohol issues and drinking habits in all patients, especially for those who seek medical advice regarding COVID-19 infection, in order to predict its severity of symptoms and potential complications. Moreover, this information should be included, in a structured field, into the Electronic Health Record to facilitate the automatic extraction of data, in real time, useful to evaluate the decision-making process in a dynamic context.
RESUMENCada vez disponemos de más información que sugiere que el sistema cannabinoide es un mecanismo crucial en la regulación de la ingesta alimentaria y en el metabolismo energético. De ahí que próximamente se vaya a comercializar un antagonista cannabinoide, el rimonabant, para su uso en obesidad que, además de una pérdida de peso, consigue una mejora del denominado síndrome metabólico, con unos cambios en el metabolismo lipídico y glucídico no observados por otros fár-macos antiobesidad actualmente comercializados. Se presenta una revisión de los conocimientos actuales sobre el tema y los datos de estudios propios: estudios genéticos de dicho sistema en los trastornos de la conducta alimentaria y en obesidad y estudios de localización de receptores cannabinoides en sitios relacionados con la ingesta. Dichos estudios apoyan un estado de hiperactividad cannabinoide en la obesidad y, además, dicha hiperactividad puede constituir un factor pronóstico. ABSTRACTThere is increasing evidence to suggest that the cannabinoid system is a crucial mechanism in the regulation of feeding and metabolism. It is against this background that a cannabinoid antagonist, rimonabant, is about to come onto the market for the treatment of obesity. Moreover, in addition to weight-loss effect, this drug has a beneficial effect on the so-called metabolic syndrome, with changes in the lipid and glucidic metabolism not observed for other anti-obesity drugs currently available. We present a review of current knowledge in this field and data from our own studies: genetic studies of this system in eating disorders and in obesity and studies of localization of cannabinoid receptors at sites related to feeding. These studies support a state of cannabinoid hyperactivity in obesity; furthermore, such hyperactivity can constitute a prognostic factor.
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