Electronic Cigarette Use and Metabolic Syndrome Development: a Critical Review.

Introduction:
This article is a critical review of existing reports on the impact of electronic cigarettes (e-cigarettes) on the development of metabolic syndrome (MetS) and its individual components, including insulin resistance, diabetes, dyslipidemia, obesity, and blood pressure. The review compares the impact of e-cigarettes use and smoking conventional cigarettes on MetS.

Key Points:

* The review identified 23 relevant studies, including 1 in vitro and animal study, 6 experimental studies using animal models, and 16 studies on the impact of e-cigarettes on their users.
* The literature search was performed using MESh terms and other relevant keywords in PubMed (including MEDLINE), CINahL Plus, Cochrane, and Web of Science data.
* The review found that e-cigarettes use could influence the level of glucose and pre-diabetic state development, increase the risk of obesity and hypertension, and affect the lipid profile.
* The impact of e-cigarettes on the development of MetS and its individual components is ambiguous, and most of the available articles have limitations in their design, methodology, and exposure time.
* animals studies were mostly based on one sex (males), and cohort studies consisted mainly of dual smokers (tobacco smokers and e-cigarettes users at once), making it difficult to assess the health effects associated only with e-cigarettes.
* The long-term health effects of e-cigarettes use are still unclear, and better assessment of e-cigarettes type and use, and further longitudinal studies, are needed to clarify the relationship.

Main Message:
The review highlights the need for further research on the impact of e-cigarettes on MetS and its individual components. While e-cigarettes are considered a safer alternative to conventional cigarettes, their long-term health effects are still unclear, and better assessment of e-cigarettes type and use is necessary to clarify the relationship. The review suggests that e-cigarettes could influence the level of glucose and pre-diabetic state development, increase the risk of obesity and hypertension, and affect the lipid profile, but further studies are needed to confirm these findings. Overall, the review emphasizes the importance of continued research and regulation to ensure the safety and public health impact of e-cigarettes.

Górna I, Napierala M, Florek E. Electronic Cigarette Use and Metabolic Syndrome Development: a Critical Review. Toxics. 2020;8(4). doi:10.3390/toxics8040105