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

Background To unravel the risk factors of systemic lupus erythematosus (SLE) complicated with tuberculosis (TB) infection through a systematic review and meta-analysis. Methods 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. Results 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. Conclusion 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. Prospero registry number CRD42024583278.