Association between e-cigarette smoking and insulin resistance using the triglyceride-glucose index in Korean adults: Korea National Health and Nutrition Examination Survey

• Published in: Korean journal of family medicine Vol. 46; no. 5; pp. 327 - 332
• Main Authors: Lim, Dahae, Choi, Jung In, Kwon, Ryuk Jun, Lee, Sang Yeoup, Cho, Young Hye, Park, Eun Ju, Lee, Youngin, Lee, Sae Rom, Son, Soo Min, Kim, Yun Jin, Lee, Jeong Gyu, Yi, Yu Hyeon, Tak, Young Jin, Lee, Seung Hun, Kim, Gyu Lee, Ra, Young Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한가정의학회 01.09.2025
• Subjects: 가정의학; Triglyceride-Glucose Index; Electronic Nicotine Delivery Systems; Insulin Resistance; Smoking
• ISSN: 2092-6715; 2005-6443; 2092-6715
• DOI: 10.4082/kjfm.23.0141

Background: Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.Methods: This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.Results: E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=9.35; never: mean=9.18; P<0.001). The ecigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03–1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03–2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14–12.30).Conclusion: Our findings suggest that e-cigarette use is significantly associated with insulin resistance.