First US study linking e-cig use to metabolic syndrome; dual use worse than smoking

The list of diseases associated with e-cigarette use keeps growing.

Metabolic syndrome is a cluster of conditions characterized by abdominal obesity, abnormal blood lipids, elevated blood pressure, and elevated blood sugar. Metabolic syndrome increases the risk of cardiovascular disease, kidney disease, and cancer among other outcomes. Earlier research from Korea found an association between e-cigarette use and metabolic syndrome. Now Jiahui Cai and Aurelian Bidulescu have shown the same thing in the United States. Their paper Associations between e-cigarette use or dual use of e-cigarette and combustible cigarette and metabolic syndrome: Results from the National Health and Nutrition Examination Survey (NHANES) uses the National Health and Nutrition Examination Survey to determine the association between e-cigarette use and metabolic syndrome.

Compared with never e-cigarette users, they found a significant increase in the odds of having metabolic syndrome or 1.30 (95% CI: 1.13, 1.50) and 15% (95% CI: 1.03, 1.28) more likely to have MetS.

The prevalence of MetS for dual users were 1.35-fold (95% CI: 1.15, 1.58) higher
than that for never smokers and 1.21-fold (95% CI: 1.00, 1.46) higher than that for combustible cigarette-only
users

Here is the abstract:

Purpose: Examine associations between e-cigarette use or dual use of e-cigarette and combustible cigarette and metabolic syndrome (MetS).

Methods: Cross-sectional data of 5,121 U.S. adults (weighted n=234,283,205) from the National Health and Nutrition Examination Survey were analyzed. Weighted multivariable Poisson regression models were used to examine associations between e-cigarette use or dual use and MetS and its components. Prevalence ratios (PRs) with 95% confidence intervals (95% CI) were estimated.

Results: Compared with never e-cigarette users, current and former e-cigarette users were 30% (95% CI: 1.13, 1.50) and 15% (95% CI: 1.03, 1.28) more likely to have MetS. Current e-cigarette use was also associated with elevated triglycerides and reduced high-density lipoprotein (HDL) cholesterol and former e-cigarette use was associated with elevated triglycerides, elevated fasting glucose, and elevated blood pressure (AOR ranged from 1.15 to 1.42, all P<0.05). The prevalence of MetS for dual users were 1.35-fold (95% CI: 1.15, 1.58) higher than that for never smokers and 1.21-fold (95% CI: 1.00, 1.46) higher than that for combustible cigarette-only users. Dual users were also more likely to report elevated triglycerides and reduced HDL cholesterol than never smokers or combustible cigarette-only users (AOR ranged from 1.21 to 1.54, all P<0.05).

Conclusions: E-cigarette use or dual use is associated with MetS. Our findings may inform tobacco control policies regarding regulations of e-cigarette use and longitudinal studies assessing metabolic risks of e-cigarette use.

The full citation is: Cai J, Bidulescu A. Associations between e-cigarette use or dual use of e-cigarette and combustible cigarette and metabolic syndrome: Results from the National Health and Nutrition Examination Survey (NHANES). Ann Epidemiol. 2023 May 16:S1047-2797(23)00094-7. doi: 10.1016/j.annepidem.2023.05.009. Epub ahead of print. PMID: 37201667. It is available here.