Chua Monica Hui Yan, Ng Irene Ai Ting, W L-Cheung Mike, Mak Anselm
M.H. Chua, MBBS, I.A. Ng, MBBS, Division of Rheumatology, Department of Medicine, National University of Singapore.
M.W. Cheung, PhD, Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore.
J Rheumatol. 2020 Oct 1;47(10):1514-1521. doi: 10.3899/jrheum.190733. Epub 2019 Dec 1.
The association between cigarette smoking and the risk of systemic lupus erythematosus (SLE) remains a matter for debate. Additionally, the effect of the change of smokers' demographics on the risk of development of SLE over time has not been formally addressed. We aimed to examine the association between cigarette smoking and the risk of SLE by performing an updated metaanalysis.
A literature search using keywords including "lupus," "smoking," "cigarette," "environmental," "autoimmune," and "connective tissue disease" was performed in computerized databases to identify studies addressing the relationship between cigarette smoking and SLE occurrence. A Bayesian metaanalysis was conducted by computing the log-OR between current and never smokers, and between former and never smokers. The average log-OR (subsequently converted to OR) and their corresponding 95% credible intervals (CrI) were calculated. The effect of publication time, sex, and age of patients with SLE on the effect sizes was examined by multivariate metaregression.
Data aggregation of 12 eligible studies comprising 3234 individuals who developed SLE and 288,336 control subjects revealed a significant association between SLE occurrence and current smoking status (OR 1.54, 95% CrI 1.06-2.25), while only a non-significant trend was demonstrated between SLE occurrence and former smoking status (OR 1.39, 95% CrI 0.95-2.08). Publication time, sex, and the mean age of patients with SLE did not explain the heterogeneity of the effect sizes.
Current smoking status is associated with risk of SLE. Sex and age of patients with SLE had no significant effect on the risk of SLE over time.
吸烟与系统性红斑狼疮（SLE）风险之间的关联仍存在争议。此外，吸烟者人口统计学特征的变化对SLE发病风险随时间的影响尚未得到正式探讨。我们旨在通过进行一项更新的荟萃分析来研究吸烟与SLE风险之间的关联。
在计算机化数据库中使用包括“狼疮”“吸烟”“香烟”“环境”“自身免疫”和“结缔组织病”等关键词进行文献检索，以识别探讨吸烟与SLE发生关系的研究。通过计算当前吸烟者与从不吸烟者之间以及既往吸烟者与从不吸烟者之间的对数比值比（log-OR）进行贝叶斯荟萃分析。计算平均对数比值比（随后转换为比值比）及其相应的95%可信区间（CrI）。通过多变量元回归研究SLE患者的发表时间、性别和年龄对效应大小的影响。
对12项符合条件的研究进行数据汇总，这些研究包括3234例发生SLE的个体和288,336例对照受试者，结果显示SLE发生与当前吸烟状态之间存在显著关联（比值比1.54，95% CrI 1.06 - 2.25），而SLE发生与既往吸烟状态之间仅显示出非显著趋势（比值比1.39，95% CrI 0.95 - 2.08）。SLE患者的发表时间、性别和平均年龄并不能解释效应大小的异质性。
当前吸烟状态与SLE风险相关。SLE患者的性别和年龄对SLE风险随时间的变化没有显著影响。
