Effect of Smoking and E-cigarette(Vape) on Liver Enzymes and Lipid Profile in Iraqi People with Dyslipidemia and Liver Disease

There is an increased trend of e-cigarette but the toxic effects of e-cigarette metabolites are not widely studied especially in liver disease. Study showed  evaluate the prevalence and patterns of recent e-cigarette use in a nationally representative sample of Iraqi  adults are association with liver disease and revealed a significant association between e-cigarette use, dyslipidemia, in Iraqi adults and adolescents. 88% of e-cigarette users with comorbid liver disease and dyslipidemia exhibited elevated liver enzyme levels, underscoring a potential pathophysiological interplay between lipid dysregulation and hepatotoxicity. Among hepatic biomarkers, serum gamma-glutamyl transferase (GGT) demonstrated the strongest independent correlation with lipid profile derangements, positioning GGT and hyperlipidemia as critical biomarkers for monitoring lipid-induced hepatic injury and its clinical progression.  liver disease exhibited lower e-cigarette use prevalence compared to non smoker (6.4%)  smokers (7.2%), multivariate logistic regression identified e-cigarette use (OR: 1.06; 95% CI: 1.05–1.06, *p*<0.0001) and non smoker (OR: 1.50; 95% CI: 1.50–1.51, p<0.0001) as independent risk factors for liver disease history. Paradoxically, despite lower absolute e-cigarette use frequency in liver disease cohorts, the elevated odds ratios highlight a disproportionate risk burden in dyslipidemic individuals. Additionally, traditional cigarette smokers showed significantly higher hemoglobin (Hb) levels than e-cigarette users, implying divergent systemic effects of smoking types.