Risk factors for systemic lupus erythematosus complicated with tuberculosis infection: meta-analyses and systematic reviews

TL;DR

This study identifies risk factors for people with lupus who also develop tuberculosis, including male gender, certain blood conditions, diabetes, and high steroid use.

Contribution

The study provides a comprehensive meta-analysis of risk factors for SLE patients developing TB, including both clinical and demographic factors.

Findings

Male gender, lymphocytopenia, and diabetes are significant risk factors for SLE complicated with TB.

Cumulative glucocorticoid dosage and a history of TB exposure are also strong risk factors.

Anemia and hypoalbuminemia were found to increase the risk of TB in SLE patients.

Abstract

To unravel the risk factors of systemic lupus erythematosus (SLE) complicated with tuberculosis (TB) infection through a systematic review and meta-analysis.

PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant research articles on systemic lupus erythematosus with TB infection from inception to June 12, 2024. Analyses of the data were performed with Stata 15.0.

The analysis incorporated 19 articles, comprising nine case-control and 10 cohort studies. In these studies, 1,292 patients with SLE complicated with TB infection and 5,703 SLE patients without TB infection were evaluated. The meta-analysis findings elucidated several pivotal risk factors with statistical significance: male (odds ratio (OR) = 1.32, 95% confidence interval (CI) [1.06–1.64], probability value (P) = 0.011), lymphocytopenia (OR = 2.65, 95% CI [1.98–3.55], P = 0.000), anemia (OR = 2.53, 95% CI [1.11–5.77], P = 0.001), hypoalbuminemia (OR = 3.46, 95% CI [1.26–9.50], P = 0.016), diabetes (OR = 3.05, 95% CI [1.63–5.71], P = 0.000). Results of multivariate analysis identified lymphocytopenia (OR = 2.90, 95% CI [1.89–4.45], P = 0.000), cumulative glucocorticoids dosage (OR = 4.88, 95% CI [1.85–12.91], P = 0.001), and a history of TB exposure (OR = 3.38, 95% CI [1.16–9.86], P = 0.026) as risk factors for SLE complicated with TB infection.

Based on available evidence, males, lymphocytopenia, anemia, hypoalbuminemia, diabetes, cumulative glucocorticoids dosage, and the TB exposure history are risk factors for SLE complicated with TB infection.

CRD42024583278.

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