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Serum/plasma homocysteine levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis

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Abstract

Published studies have shown contradictory results in the association of serum/plasma levels of homocysteine (HCY) with systemic lupus erythematosus (SLE). This study is to systematically evaluate the association of serum/plasma HCY levels in SLE. A search was done using PubMed, Embase, Web of Science, and ScienceDirect databases up to 7 April 2019. Thirty-six articles including 2919 SLE patients and 3120 healthy controls were finally included in this meta-analysis. The HCY levels were significantly higher in SLE patients than in healthy controls (P < 0.001). The subgroup analysis revealed that Asian, African, Arab, Mixed, White and others as well as ages (< 35 and ≥ 35) had significant higher HCY levels in SLE patients than in the healthy controls. The study indicated that patients with disease activity index scores < 8 (P < 0.001) and ≥ 8 (P = 0.003) of SLE had significant higher HCY levels as compared with the healthy controls. It was also revealed that disease duration in SLE patients for < 10 and ≥ 10 years (P < 0.001) had significant higher HCY levels as compared with the healthy controls. A significant higher HCY level for body mass index (< 23 and ≥ 23) was found as well as measurement type in SLE patients than healthy controls. This meta-analysis demonstrated higher HCY levels in patients with SLE than healthy controls, suggesting a possible role of HCY in the disease.

Key Points

• Homocysteine (HCY) is closely related to the mechanisms of systemic lupus erythematosus (SLE).

• This study reveals a significant correlation between HCY levels and the various indexes of disease activity.

• This study reveals that medication may influence HCY levels in SLE.

• This study also discovers that the subgroup analysis of all the factors influences the HCY levels in SLE patients.

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Funding

This study was successfully done by the help of a grant from the National Natural Science Foundation of China. The grant numbers are as follows: 81573222 and 81473058.

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Authors and Affiliations

  1. Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China

    Napoleon Bellua Sam, Qin Zhang, Bao-Zhu Li, Hai-Feng Pan & Dong-Qing Ye

  2. Anhui Province Key Laboratory of Major Autoimmune Diseases, 81 Meishan Road, Hefei, Anhui, China

    Napoleon Bellua Sam, Qin Zhang, Bao-Zhu Li, Hai-Feng Pan & Dong-Qing Ye

  3. Department of Rheumatology and Immunology, Anhui Provincial Hospital, 17 Lujiang Road, Hefei, Anhui, China

    Xiao-Mei Li

  4. Department of Nephrology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China

    De-Guang Wang

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  1. Napoleon Bellua Sam
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Sam, N.B., Zhang, Q., Li, BZ. et al. Serum/plasma homocysteine levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Clin Rheumatol 39, 1725–1736 (2020). https://doi.org/10.1007/s10067-020-04985-w

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