Association between electronic cigarette and combustible cigarette use with cardiometabolic risk biomarkers among U.S. adults.

ABSTRACT

PURPOSE: To determine the association between cigarette use (i.e., never-use - reference group, exclusive e-cigarette users, exclusive cigarette smoking, and dual use of both products) with cardiometabolic risk biomarkers. METHODS: Data came from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey. We used weighted logistic regression models to determine the association of cigarette use and reduced high-density lipoprotein cholesterol (HDL-C; <40 mg/dL, for men and <50 mg/dL for women), elevated low-density lipoprotein cholesterol (LDL-C; ≥130 mg/dL), elevated triglycerides (TG; ≥150 mg/dL), elevated fasting blood glucose (FBG; (≥100 mg/dL), and high blood pressure (HBP; Systolic ≥130 mm Hg/Diastolic ≥85 mm Hg). RESULTS: Of the 8688 adults 18+ years of age included, 2.7%, 3.2%, and 14.9% self-reported exclusive e-cigarette, dual use, and exclusive cigarette smoking respectively. After adjusting for covariates, exclusive e-cigarette use was significantly associated with increased odds of HBP (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI] = 1.03, 4.08). Dual use was associated with increased odds of reduced HDL-C (aOR = 1.64, 95% [CI] = 1.01, 2.70). Exclusive cigarette smoking was significantly associated with reduced HDL-C (aOR=1.80, 95% [CI]=1.45, 2.23) and elevated TG (aOR = 1.59, 95% [CI] = 1.01, 2.52). CONCLUSIONS: Results are preliminary and warrant replication from larger samples with longitudinal follow-up.