Environmental Factors (External Exposome) and Rare Immunological Diseases (Systemic Lupus Erythematosus): Is Smoking a Risk Factor or Protective Factor?

Introduction: The interaction between genetic and environmental factors influencing susceptibility to the development of systemic lupus erythematosus (SLE) is widely described in the literature. The strongest epidemiological evidence, largely from the North, exists in favor of an increased risk of SLE associated with exposure to current smoking, and a protective effect of moderate alcohol consumption associated against the development of SLE. The north-south differences in genetic and environmental characteristics in patients with SLE is openned research question in literature. We do not know whether there is a contrast between these genetic and environmental characteristics of lupus patients from the Northern society and those from the Southern society, particularly Malian lupus patients. The aim of this study was to determine external exopsome such sociodemographic and environnemental factors associated with increasing or decreasing risk to develop the systemic lupus erythematosus. Method: We conducted a cross-sectional study with retropective data collection from the medical records of patients hospitalized for autoimmune and/or autoinflammatory diseases in the Department of Internal Medicine at the University Hospital Center of the Point G between January 01, 2005 to December 31, 2019, i.e. 15 years. We performed a univariate analysis to obtain mean and standard deviation for quantitative data and numbers and percentages for qualitative data. In the bivariate analysis, the Chi-square and Fisher´s exact tests were used to assess the statistical significance and strength of the associations between the categorical independent variables (age, age group, sex, lifestyle) and the outcome variables (systemic lupus erythematosus). Variables with a Chi-square test with p < 0.2 at bivariate analysis were included in a multivariate logistic regression.