Association Between Electronic Cigarette Use and Levels of High-Sensitivity C-Reactive Protein and Uric Acid

Abstract

The present study investigated whether electronic cigarette use, which is becoming increasingly common, was related to systemic inflammation that may lead to cardiovascular disease, similar to conventional cigarette smoking. The study included 1208 men (19-65 years old) who participated in the 7th Korean National Health and Nutrition Examination Survey (2016). The participants were categorized as electronic cigarette users, conventional cigarette users, and nonsmokers. Serum high-sensitivity C-reactive protein was used as an inflammatory index, and uric acid level was used as a metabolic indicator. After adjusting for confounding factors, electronic cigarette use was significantly associated with elevated serum high-sensitivity C-reactive protein levels (β = 1.326, P = .002), uric acid levels (β = 0.400, P = .042), and hyperuricemia (uric acid level of >7 mg/mL; odds ratio = 2.67, 95% confidence interval = 1.27-5.58). These findings suggest that electronic cigarette use may be associated with systemic inflammation markers, similar to conventional cigarette use.

E-Cigarette Use, Systemic Inflammation, and Depression

“…Our findings from bivariate analyses are consistent with, and seemingly build upon, reports of independent associations between e-cigarette use and depression, and depression and elevated CRP [4,5,12,37,38], and a lack of evidence for a significant association between elevated CRP and e-cigarette use [42,43]. Similar to previous studies, we found that fewer women use e-cigarettes, yet are at elevated risk for depression (50%) and serum CRP ≥ 8.0 mg/L (100%) compared to men (Table 2) [38,[44][45][46][47].…”

“…It is well accepted that smokers are more likely to experience depression compared to non-smokers [ 35 , 36 ], and a number of studies have found that e-cigarette users also are at greater risk for depression [ 4 , 5 , 6 , 37 ]. Separately, both vaping and depression have been independently associated with increased inflammation [ 11 , 12 , 38 ]. Using data from a nationally representative sample of the U.S. population, we have found evidence consistent with early findings of current e-cigarette use being associated with increased likelihood of depression, and evidence of inflammation being associated with depression.…”

“…An increasing body of literature has identified a link between e-cigarette use and inflammation (in the lung and other organs) [ 7 ]. The data from both laboratory and population-based studies suggest that vaping may promote inflammation similarly to traditional cigarettes [ 8 , 9 , 10 , 11 , 12 ], as current cigarette smokers have been found to present significantly higher levels of C-reactive protein (CRP) and other inflammatory markers [ 13 ]. Systemic inflammation is a known risk factor for myriad health conditions, including depression [ 14 , 15 , 16 ].…”

Electronic and Conventional Cigarette Exposure Aggravate Metabolic Parameters in High-Fat Diet-Induced Rats

“…In accordance, a cross-sectional study in Korea reported that cigarette and e-cigarette use was associated with increased uric acid [10], [28]. The suggested mechanism was that the use of e-cigarettes causes systemic inflammation characterized by an increase in hs-CRP, which contributes to an increase in uric acid levels and a higher risk of hyperuricemia [28]. A Brazilian study also revealed that smokers experienced increased levels of hs-CRP than non-smokers, and smokers with metabolic syndrome had high hs-CRP levels twice [8].…”

“…The use of cigarettes and e-cigarettes also seems to increase uric acid. In accordance, a cross-sectional study in Korea reported that cigarette and e-cigarette use was associated with increased uric acid [10], [28]. The suggested mechanism was that the use of e-cigarettes causes systemic inflammation characterized by an increase in hs-CRP, which contributes to an increase in uric acid levels and a higher risk of hyperuricemia [28].…”