Abstract
ObjectivesThe present study evaluated the association of electronic cigarette (EC) exposure with serum uric acid (UA) level and hyperuricemia (HUA) using a nationally representative sample of South Korea.MethodsThis study included 10,692 participants (9,905, 609, and 178, never, ever, and current EC users, respectively). Urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels were used to determine conventional smoking exposure among EC users. The association between EC use and UA level was evaluated by linear regression analysis. Multivariable logistic regression analysis was used to assess the association between EC and HUA. Subgroup analysis confined to cotinine-verified active smokers was performed to address the association between the dual use of EC and combustible cigarettes and serum UA levels.ResultsThe serum UA level was highest among current EC users, followed by ever and never EC users. The prevalence of HUA was 26.2%, 19.3%, and 10.8% in current, ever, and never EC users, respectively. Although EC exposure was positively associated with HUA in a dose-dependent manner only in men (Ptrend = 0.04), a similar tendency was also observed in women with marginal significance (Ptrend = 0.102). The positive association of HUA with EC exposure was more apparent among dual users (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.29–2.99) than among those who only smoked combustible cigarettes.ConclusionsEC exposure was associated with higher serum UA level and higher OR of HUA. The positive association between EC exposure and HUA was more prominent in dual users who concurrently consumed EC and combustible cigarettes.
Highlights
Electronic cigarette (EC) use and the consumption of vaping products are steadily increasing, especially in never and former smokers [1]
EC exposure was associated with higher serum uric acid (UA) level and higher odds ratio (OR) of HUA
The positive association between EC exposure and HUA was more prominent in dual users who concurrently consumed EC and combustible cigarettes
Summary
Electronic cigarette (EC) use and the consumption of vaping products are steadily increasing, especially in never and former smokers [1]. ECs contain chemical components including nicotine, humectants (glycerol and glycol), heavy metals, and volatile organic compounds, they are considered less toxic than conventional cigarettes (CCs) because CCs deliver significantly higher levels of harmful and potentially harmful constituents than ECs [2]. ECs are widely used as a substitute for CCs and about 25% of current smokers use ECs as a alternative or together with CC [3]. One study in healthy participants revealed that short-term exposure to EC increased respiratory flow resistance and airway resistance [5], and another study reported persistent airflow limitation and respiratory bronchiolitis after exposure to long-term use of high-dose EC [6]. Histopathological examinations showed hepatotoxicity and nephrotoxicity of ECs [7, 8]
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