Abstract
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.