ArticleArthritis & rheumatology (Hoboken, N.J.)2022
Association of a Combination of Healthy Lifestyle Behaviors With Reduced Risk of Incident Systemic Lupus Erythematosus.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of lifestyle interventions in the management of systemic lupus erythematosus: a systematic review of the literature.Rheumatology international · 2024Pooled it
- From genes to environment: A life-course approach to prevent pediatric autoimmune diseases.World journal of clinical pediatrics · 2026Review
- Modifiable lifestyle factors in early life and inflammatory bowel disease risk in two birth cohorts.Journal of Crohn's & colitis · 2026Article
- Dietary and Nutritional Factors in Systemic Lupus Erythematosus Pathophysiology: A Scoping Review of the Evidence from In Vitro, In Vivo, and Human Studies.Advances in nutrition (Bethesda, Md.) · 2026Article
- Assessing the real-world impact of interstitial lung disease in patients with rheumatoid arthritis on healthcare resources and treatment patterns through natural language processing.EULAR rheumatology open · 2026Article
- 3D Bioprinting Strategies in Autoimmune Disease Models.International journal of molecular sciences · 2025Review
- Environmental Risk Factors for Systemic Lupus Erythematosus Through the Lens of Social Determinants of Health.Arthritis care & research · 2025Review
- Systemic lupus erythematosus: updated insights on the pathogenesis, diagnosis, prevention and therapeutics.Signal transduction and targeted therapy · 2025Review
- Ultraprocessed Food Intake and Risk of Systemic Lupus Erythematosus Among Women Observed in the Nurses' Health Study Cohorts.Arthritis care & research · 2025Article
- Development of a predictive model for systemic lupus erythematosus incidence risk based on environmental exposure factors.Lupus science & medicine · 2024Article
- Distinct mucosal endotypes as initiators and drivers of rheumatoid arthritis.Nature reviews. Rheumatology · 2024Review
- Environment and systemic autoimmune rheumatic diseases: an overview and future directions.Frontiers in immunology · 2024Review
- Factors influencing self-management behaviors in persons with lupus nephritis: A cross-sectional study.Belitung nursing journal · 2024Article
- Association of Sleep Deprivation and the Risk of Developing Systemic Lupus Erythematosus Among Women.Arthritis care & research · 2023Article
- From real-world electronic health record data to real-world results using artificial intelligence.Annals of the rheumatic diseases · 2023Review
- Differential impact of environmental factors on systemic and localized autoimmunity.Frontiers in immunology · 2023Review
- The Intersection of Cellular and Systemic Metabolism: Metabolic Syndrome in Systemic Lupus Erythematosus.Endocrinology · 2022Review
- The role of environmental exposures and gene-environment interactions in the etiology of systemic lupus erythematous.Journal of internal medicine · 2022Review
- Sex-Specific Environmental Impacts on Initiation and Progression of Multiple Sclerosis.Frontiers in neurology · 2022Review
- Understanding the Concept of Pre-Clinical Autoimmunity: Prediction and Prevention of Systemic Lupus Erythematosus: Identifying Risk Factors and Developing Strategies Against Disease Development.Frontiers in immunology · 2022Review
Corrections and comments
- Commented on by
- Commented on byReply.2022
Authors and funding
9 authors.
Funding
Abstract
objectiveWhile previous studies have demonstrated an association between individual factors related to lifestyle and the risk of systemic lupus erythematosus (SLE), it is unclear how the combination of these factors might affect the risk of incident SLE. This study was undertaken to prospectively evaluate whether a combination of healthy lifestyle factors is associated with a lower risk of incident SLE and its subtypes (anti-double-stranded DNA [anti-dsDNA]-positive and anti-dsDNA-negative SLE).
methodsThe study included 185,962 women from the Nurses' Health Study (NHS) and NHSII cohorts, among whom there were 203 incident cases of SLE (96 with anti-dsDNA-positive SLE, 107 with anti-dsDNA-negative SLE) during 4,649,477 person-years of follow-up. The Healthy Lifestyle Index Score (HLIS) was calculated at baseline and approximately every 2 years during follow-up, with scores assigned for 5 healthy lifestyle factors: alcohol consumption, body mass index, smoking, diet, and exercise. A time-varying Cox proportional hazards regression model was used to estimate the adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the risk of SLE. In addition, the percentage of partial population attributable risk (PAR%) of SLE development was calculated.
resultsA higher HLIS was associated with a lower risk of SLE overall (HR 0.81 [95% CI 0.71-0.94]) and a lower risk of anti-dsDNA-positive SLE (HR 0.78 [95% CI 0.63-0.95]). Women with ≥4 healthy lifestyle factors had the lowest risk of SLE overall (HR 0.42, 95% CI 0.25-0.70) and lowest risk of anti-dsDNA-positive SLE (HR 0.35, 95% CI 0.17-0.75) as compared to women with only 1 healthy behavior or no healthy behaviors. The PAR% of SLE development was 47.7% (95% CI 23.1-66.6%), assuming that the entire population had adhered to at least 4 healthy lifestyle behaviors.
conclusionThese results indicate that the risk of developing SLE, a disease in which significant evidence of genetic involvement has been established, might be reduced by nearly 50% with adherence to modifiable healthy lifestyle behaviors.
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