The association between e-cigarette use and dyslipidemia: A systematic review and meta-analysis of observational studies.
Humam Emad Rajha, Sara Mohsen, Hadeel Alkuwari et al.
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In 30 seconds
This systematic review and meta-analysis examined observational evidence on exclusive e-cigarette use and blood lipids in adults. Seven studies from four countries included 25,690 participants. Vaping was associated with higher odds of hypertriglyceridemia (aOR 3.10, 95% CI 1.18 to 8.16) and low HDL (aOR 3.26, 95% CI 2.28 to 4.65). Unadjusted analyses also found higher LDL and VLDL, but no statistically significant difference in total cholesterol. GRADE certainty was very low for all outcomes, so the findings do not establish that vaping causes dyslipidemia.
Key findings
- E-cigarette use was associated with higher odds of hypertriglyceridemia (aOR 3.10, 95% CI 1.18 to 8.16; I2 = 80.1%).
- Use was associated with higher odds of low HDL (aOR 3.26, 95% CI 2.28 to 4.65; I2 = 3.1%).
- Unadjusted LDL was higher by uWMD +12.40 mg/dL (95% CI 7.91 to 16.88); VLDL was higher by uWMD +3.23 mg/dL (95% CI 1.43 to 5.02).
- Total cholesterol did not differ significantly: uWMD +3.66 mg/dL (95% CI -13.89 to 21.20).
Why it matters
Lipid abnormalities are relevant to cardiovascular risk assessment, and these pooled observational findings suggest a possible association between vaping and several adverse lipid measures. However, the evidence is very uncertain and cannot establish causation. The results highlight an unresolved question about vaping’s cardiometabolic effects rather than demonstrating a clinical effect or quantifying individual risk.
What to keep in mind
All included evidence was observational and GRADE certainty was very low. Heterogeneity was substantial for some outcomes, and insufficient stratified reporting prevented planned subgroup analyses by age and sex.