title: Smoking and the risk of systemic lupus erythematosus: an updated systematic review and cumulative meta-analysis.
abstract: Published articles reported controversial results about the association of smoking with the risk of systemic lupus erythematosus (SLE). A meta-analysis was performed to assess the aforementioned association and arrive at a more precise estimate of effect. A comprehensive search was performed to identify case-control or cohort studies (from 1990 to 2015) of the aforementioned association. The I (2) statistic was used to examine between-study heterogeneity. Fixed or random effect model was selected based on heterogeneity test among studies. Publication bias was estimated using Egger's regression asymmetry test. A total of 12 published articles with 13 studies were finally included in our meta-analysis. Results showed that the pooled odds ratio (OR) for SLE risk was 1.56 (95% confidence interval (CI) = 1.26-1.95) among current smokers compared with nonsmokers. For ex-smokers versus nonsmokers, the pooled OR for SLE risk was 1.23 (95% CI = 0.93-1.63). Subgroup analysis by geographic location and cumulative meta-analysis were also analyzed. In conclusion, our meta-analysis suggested that smoking increased the risk of SLE. Further studies are needed to confirm this result.
authors.affiliation: Department of Epidemiology, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
authors.forename: Fan
authors.initials: F
authors.lastname: Jiang
authors.affiliation: Department of Epidemiology, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
authors.forename: Suyun
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Epidemiology, Shandong University, Jinan, 250012, Shandong, People's Republic of China. jiachongqi@sdu.edu.cn.
authors.forename: Chongqi
authors.initials: C
authors.lastname: Jia
mesh_terms: D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D016017:Odds Ratio; D017594:Publication Bias; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
keywords: Meta-analysis; Risk; Smoking; Systemic lupus erythematosus