Abstract
Electronic cigarette vaping has recently been chosen as a smoking alternative for those who want to quit smoking, but some of the electronic cigarette users use both traditional and electronic cigarettes (dual smoking) without stopping smoking. This study investigated the association between smoking behavior and metabolic syndrome among Korean adults. Data from 14,607 participants (6142 males and 8465 females) were examined. They were divided into four categories: dual smoking (both conventional and e-cigarettes), single smoking (only conventional cigarettes), previously smoking, and non-smoking. Metabolic syndrome risk was calculated as a continuous variable using the lipid accumulation product (LAP) index. Multiple linear regression analyses were performed to examine the association of log-transformed LAP with smoking behavior. Among the total participants, 187 males and 35 females were dual smokers and 1850 males and 372 females were single smokers. LAP was significantly higher in male who practiced dual and single smoking than LAP of non-smokers—dual: β = 0.27, standard error (SE) = 0.06, p < 0.0001; single: β = 0.18, SE = 0.03, p < 0.0001. In female, LAP was significantly higher among those who practiced only single smoking than LAP of non-smokers (β = 0.21, SE = 0.04, p < 0.0001). Dual and single smoking were significantly associated with higher LAP, a strong predictor of metabolic syndrome. Further studies and awareness regarding the adverse effects of dual smoking are required.
Highlights
The prevalence of metabolic syndrome (MetS) is increasing worldwide and is known to negatively affect health in many ways [1]
The mechanisms associated with MetS have not yet been clarified and it is still debatable whether obesity, insulin resistance, or inflammation are its causative factors
lipid accumulation product (LAP) is a useful indicator for evaluating visceral fat, which is calculated including waist circumference (WC) and TG, and is considered as the most powerful predictor of MetS [13,14,37]
Summary
The prevalence of metabolic syndrome (MetS) is increasing worldwide and is known to negatively affect health in many ways [1]. The mechanisms associated with MetS have not yet been clarified and it is still debatable whether obesity, insulin resistance, or inflammation are its causative factors. It is well known that smoking, lack of exercise, and unbalanced eating habits are the risk factors for MetS among various other environmental and lifestyle factors [7,8]. Various indicators, such as body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-to-height ratio, were adopted to evaluate the association between MetS and lifestyle [9,10,11]. The recently introduced lipid accumulation product (LAP) index is emerging as a reliable tool to detect MetS because it shares two of its five indicators [12,13,14]. The LAP is an indicator for assessing excessive central and visceral fat accumulation based on the concentration
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