Tunagur, Mustafa TolgaKurt Tunagur, Elif Merve2026-02-032026-02-0320261557-18741557-1882https://doi.org/10.1007/s11469-025-01622-yhttps://hdl.handle.net/20.500.12428/34925The growing use of cannabis and synthetic cannabinoids (SCs) among adolescents raises concerns about their distinct physiological effects. This retrospective case-control study evaluated systemic inflammatory indices in 88 adolescents with cannabinoid use disorder (CUD) (mean age = 16.42 +/- 1.06 years; 51.1% male)-subdivided into Cannabis-CUD, SC-CUD, and Dual-CUD groups-compared with 50 healthy controls (mean age = 16.14 +/- 0.80 years; 40% male). & Idot;nflammatory indices, neutrophil-, basophil-, monocyte-, and platelet-to-lymphocyte ratios (NLR, BLR, MLR, PLR, dNLR, and NLPR), and systemic inflammatory indices (SII, SIRI, and AISI), were analyzed using ANOVA and ROC curve analysis. NLR, dNLR, BLR, SII (all p < .001), and NLPR, PLR, SIRI, AISI (p < .05) were significantly higher in the CUD group compared to healthy controls. Compared to controls, SC-CUD showed significantly higher inflammatory indices (p < 0.001 for NLR, BLR, and SII), while Dual-CUD showed moderate elevations (p = 0.009, p = 0.027, and p = 0.003 for NLR, BLR, and SII, respectively). For cannabis-CUD, BLR was the only marker that significantly differed from controls (p = 0.019). ROC analysis identified BLR (AUC = 0.72), SII (AUC = 0.71), and NLR (AUC = 0.70) as the strongest predictors of CUD. These findings highlight the comparatively higher inflammatory indices observed in the synthetic cannabinoid groups and suggest that blood-based indices may help identify adolescents at elevated physiological risk associated with cannabinoid use.eninfo:eu-repo/semantics/closedAccessCannabis use disorderSynthetic cannabinoidsInflammationAdolescentNeutrophil-to-lymphocyte ratioSystemic inflammation indexBiomarkersArticle10.1007/s11469-025-01622-yQ2WOS:001662991900001