Abstract
ObjectivesAlthough smoking is known to have a negative impact in patients with metabolic syndrome (MetS), only a few studies have examined the association between electronic cigarette (e-cig) use and MetS.MethodsAmong 22,948 participants in the 6th Korea National Health and Nutrition Examination Survey, 14,738 (13,459 [91.3%] never, 954 [6.5%] ever, and 325 [2.2%] current e-cig users) were selected. The relationship between e-cig exposure and MetS (based on the National Cholesterol Education Program Adult Treatment Panel [NCEP-ATP] III criteria) was evaluated using a multivariable logistic regression analysis. An unweighted analysis was performed to evaluate this association without a sampling weight. A subgroup analysis was performed among active smokers to compare dual users with never e-cig users.ResultsAmong current e-cig users, 85.0% were dual users, 12.7% were former cigarette users, and 2.2% were only e-cig users. After adjustment for covariates, abdominal obesity and hypertriglyceridemia were significantly associated with current e-cig exposure (odds ratio [OR]: 1.88, 95% confidence interval [CI]: 1.41–2.50 and OR: 1.32, 95% CI: 1.00–1.74 respectively [compared with the never e-cig users group]). Compared with never e-cig users, current e-cig users showed an OR of 1.27 (95% CI: 0.96–1.70, Ptrend = 0.01) for MetS. In the unweighted analysis, the OR for MetS in current e-cig users was 1.40 (95% CI: 1.08–1.81, Ptrend <0.01). Compared with never e-cig users, dual users showed a higher OR for abdominal obesity (OR: 1.71, 95% CI: 1.25–2.34, Ptrend <0.001).ConclusionsCurrent e-cig exposure was associated with an increased risk of MetS. Dual use of e-cigs and cigarettes was associated with abdominal obesity. Further longitudinal studies and better assessment of e-cig use and type are needed to clarify this relationship.
Highlights
Since their introduction in 2007, the popularity of electronic cigarettes (e-cigs) has steadily increased among young populations, with 27.5% of high school students and 10.5% of middle school students reporting the use of e-cigs in 2019 [1]
After adjustment for covariates, abdominal obesity and hypertriglyceridemia were significantly associated with current e-cig exposure
Compared with never e-cig users, current ecig users showed an odds ratios (ORs) of 1.27 for metabolic syndrome (MetS)
Summary
Since their introduction in 2007, the popularity of electronic cigarettes (e-cigs) has steadily increased among young populations, with 27.5% of high school students and 10.5% of middle school students reporting the use of e-cigs in 2019 [1]. In France, more than 80% of current e-cig users were dual users, and low income levels and unemployment were associated with high a probability of dual use [3]. As the e-cig-consuming population increases, various adverse health effects have been reported. E-cigs contain several chemical components; the actual composition of this product is not well known and there is a significant gap in the data on their health effects. In a crossover single-blind study conducted in 40 healthy individuals, several markers of oxidative stress were not different between e-cig users and traditional cigarette users [4]. Kaur et al summarized the prolonged effects of e-cig consumption and concluded that long-term e-cig exposure may result in systemic inflammation [5]
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