Association between electronic cigarette use and metabolic syndrome in the Korean general population: A nationwide population-based study

• Published in: PloS one Vol. 15; no. 8; p. e0237983
• Main Authors: Kim, Taeyun, Choi, Hyunji, Kang, Jihun, Kim, Jehun
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 21-08-2020; Public Library of Science (PLoS)
• Subjects: Age; Alcohol; Alcohol use; Biology and Life Sciences; Cholesterol; Cigarette smoking; Cigarettes; Confidence intervals; Correlation analysis; Electronic cigarettes; Evaluation; Exercise; Exposure; Health aspects; Hospitals; Hypertriglyceridemia; Institutionalization; Internal medicine; Longitudinal studies; Medicine; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Metabolic syndrome X; Nutrition; Obesity; Population; Population studies; Population-based studies; Regression analysis; Risk factors; Smokers; Smoking; Social Sciences; Statistical analysis; Studies; Subgroups; Surveys; Vaping; Womens health; South Korea; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0237983

Although 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. Among 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. Among 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, P.sub.trend = 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, P.sub.trend <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, P.sub.trend <0.001). Current 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.