Elucidating the environmental risk factors for rheumatic diseases: An umbrella review of meta-analyses

International Journal of Rheumatic Diseases
Lazaros BelbasisE Evangelou

Abstract

Although rheumatic diseases constitute a leading cause of disability, the environmental risk factors for these diseases are not clarified. In the present study, we aim to systematically appraise the epidemiological credibility of the environmental risk factors for rheumatic diseases. We systematically searched PubMed to capture meta-analyses of observational studies on environmental risk factors for the most prevalent rheumatic diseases. For each association, we estimated the summary effect size estimate, the 95% confidence and prediction intervals, and the I2 metric. We further examined the presence of small-study effects and excess significance bias. Overall, we identified 30 eligible papers describing 42 associations. Thirty-three associations were statistically significant at P < 0.05, whereas 13 of them were statistically significant at P < 1 × 10-6 . Thirty-two associations had large or very large between-study heterogeneity. In 12 associations, evidence of small-study effects and/or excess significance bias was found. Six risk factors (nine associations) presented convincing or highly suggestive evidence of association: smoking and pack-years of smoking for rheumatoid arthritis; BMI (per 5 kg/m2 increase) for gout and hi...Continue Reading

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Citations

Jun 5, 2020·Nature Reviews. Rheumatology·Anne Grete SembSilvia Rollefstad
Aug 8, 2020·International Journal of Rheumatic Diseases·Lian ZhangQianjin Lu
Mar 18, 2020·European Journal of Epidemiology·Lazaros BelbasisEvangelos Evangelou
Jan 21, 2021·International Journal of Environmental Research and Public Health·David Rojas-RuedaMashael Alomran

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