title: Smoking and obesity in systemic lupus erythematosus: a cross-sectional study.
abstract: BACKGROUND
  Both smoking and obesity have been demonstrated as risk factors in several autoimmune diseases. Little is known about the relationship between systemic lupus erythematosus (SLE) and both smoking and obesity.
  
  
  OBJECTIVE
  To investigate the association between SLE, tobacco consumption and body mass index (BMI).
  
  
  METHODS
  Using data from the largest Health Maintenance Organization (HMO) in Israel, the Clalit Health Services, we searched for an association between SLE, smoking and obesity. Chi-square and t-test were used for univariate analysis, and a logistic regression model was used for multivariate analysis. Data available from Clalit Health Services database included age, sex, BMI, smoking status, socioeconomic status (SES) and diagnoses of chronic diseases.
  
  
  RESULTS
  The study included 5018 patients with SLE and 25 090 age- and sex-matched controls. In multivariate analysis, we found a significant association between smoking and SLE (OR = 1·91). Conversely, there was no association between BMI and SLE.
  
  
  CONCLUSIONS
  In this study, we have shown that smoking is independently associated with SLE, whereas BMI scores were not.
authors.affiliation: Department of Internal Medicine, Archet Hospital, University of Nice-Sophia-Antipolis, Nice, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Versini
authors.affiliation: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Shmuel
authors.identifier: http://orcid.org/0000-0002-1748-4297
authors.initials: S
authors.lastname: Tiosano
authors.affiliation: Chief Physician's Office, Clalit Health Services, Tel-Aviv, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Comaneshter
authors.affiliation: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
authors.affiliation: Chief Physician's Office, Clalit Health Services, Tel-Aviv, Israel.|Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
authors.affiliation: Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Howard
authors.identifier: http://orcid.org/0000-0002-5406-7716
authors.initials: H
authors.lastname: Amital
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D000073869:Tobacco Smoking / Q000009:adverse effects*
keywords: Autoimmunity; obesity; smoking; systemic lupus erythematosus