Monica Hui Yan Chua1, Irene Ai Ting Ng1, Mike W L-Cheung1, Anselm Mak1. 1. From the Division of Rheumatology, Department of Medicine; Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore; University Medicine Cluster, National University Health System, Singapore. M.H. Chua, MBBS, Division of Rheumatology, Department of Medicine, National University of Singapore; 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; A. Mak, MMedSc, MBBS, PhD, MD, FRCP, FRCPI, Division of Rheumatology, Department of Medicine, National University of Singapore, and University Medicine Cluster, National University Health System. M.H. Chua and I.A. Ng contributed equally to this work. Address correspondence to Dr. A. Mak, Associate Professor and Senior Consultant, Division of Rheumatology, Department of Medicine, 1E Kent Ridge Road, Level 10, NUHS Tower Block, Singapore 119228, Singapore. E-mail: mdcam@nus.edu.sg. Accepted for publication November 11, 2019.
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Erica C Spears; Amani M Allen; Kara W Chung; Connor D Martz; Evelyn A Hunter; Thomas E Fuller-Rowell; S Sam Lim; Christina Drenkard; David H Chae Journal: J Behav Med Date: 2021-06-22