PDF(Pubmed)
Abstract：
This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke.
We obtained data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model.
We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04-3.81), 2.36 (1.52-3.59), 2.34 (1.44-3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65-0.84), sensitivity was 0.68, and specificity was 0.75.
Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.
We obtained data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model.
We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04-3.81), 2.36 (1.52-3.59), 2.34 (1.44-3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65-0.84), sensitivity was 0.68, and specificity was 0.75.
Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.
摘要：
目的：本研究旨在分析可燃/电子烟与中风风险之间的关联。
方法：我们从2017-2018年全国健康和营养检查调查（NHANES）获得数据。通过问卷调查获得中风史和可燃/电子烟的使用。考虑到可燃香烟和电子香烟（电子香烟）的唯一或双重用途，我们把所有的人分成四个小组，包括不吸烟者（参照组），唯一的可燃香烟，唯一的电子烟，以及可燃香烟和电子香烟的双重使用。我们进行了多变量逻辑回归，以确定吸烟与中风患病率之间的关联。我们使用比值比(OR)和95%置信区间(CI)来显示效应大小。最后,我们基于随机森林模型建立了一个预测模型来评估使用可燃或电子烟的个体的卒中风险.
结果：我们共纳入4022名参与者。中位年龄为55岁，48.3%的参与者为男性。当我们调整年龄时，性别,受教育程度,种族,总HDL胆固醇（<5.9或≥5.9），糖尿病,高血压,和酒精消费，唯一使用电子烟的群体，唯一的可燃香烟使用，可燃和电子香烟的双重使用与中风的患病率显着相关（具有95CI）2.07（1.04-3.81），2.36(1.52-3.59),2.34(1.44-3.68),分别。在测试集中，AUC为0.74（95CI=0.65-0.84），敏感性为0.68,特异性为0.75.
结论：独家电子烟和电子烟与可燃香烟的双重使用可能会增加中风的风险。
方法：我们从2017-2018年全国健康和营养检查调查（NHANES）获得数据。通过问卷调查获得中风史和可燃/电子烟的使用。考虑到可燃香烟和电子香烟（电子香烟）的唯一或双重用途，我们把所有的人分成四个小组，包括不吸烟者（参照组），唯一的可燃香烟，唯一的电子烟，以及可燃香烟和电子香烟的双重使用。我们进行了多变量逻辑回归，以确定吸烟与中风患病率之间的关联。我们使用比值比(OR)和95%置信区间(CI)来显示效应大小。最后,我们基于随机森林模型建立了一个预测模型来评估使用可燃或电子烟的个体的卒中风险.
结果：我们共纳入4022名参与者。中位年龄为55岁，48.3%的参与者为男性。当我们调整年龄时，性别,受教育程度,种族,总HDL胆固醇（<5.9或≥5.9），糖尿病,高血压,和酒精消费，唯一使用电子烟的群体，唯一的可燃香烟使用，可燃和电子香烟的双重使用与中风的患病率显着相关（具有95CI）2.07（1.04-3.81），2.36(1.52-3.59),2.34(1.44-3.68),分别。在测试集中，AUC为0.74（95CI=0.65-0.84），敏感性为0.68,特异性为0.75.
结论：独家电子烟和电子烟与可燃香烟的双重使用可能会增加中风的风险。
