Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis

Jianwen Ding, Shujun Su, Tao You, Tingting Xia, Xiaoying Lin, Zhaocong Chen, Liqun Zhang, Jianwen Ding, Shujun Su, Tao You, Tingting Xia, Xiaoying Lin, Zhaocong Chen, Liqun Zhang

Abstract

Interleukin-6 (IL-6) plays a crucial role in systemic autoimmunity and pathologic inflammation. Numerous studies have explored serum IL-6 levels in systemic lupus erythematosus (SLE) and their correlation with disease activity. Here, we performed a meta-analysis to quantitatively assess the correlation between the serum IL-6 levels and SLE activity. The PubMed and EMBASE databases were thoroughly searched for relevant studies up to September 2019. Standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were used to describe the differences between serum IL-6 levels in SLE patients and healthy controls and between those in active SLE patients and inactive SLE patients. The correlation between the serum IL-6 levels and disease activity was evaluated using Fisher's z values. A total of 24 studies involving 1817 SLE patients and 874 healthy controls were included in this meta-analysis. Serum IL-6 levels were significantly higher in SLE patients than in the healthy controls (pooled SMD: 2.12, 95% CI: 1.21-3.03, Active SLE patients had higher serum IL-6 levels than inactive SLE patients (pooled SMD: 2.12, 95% CI: 1.21-3.03). Furthermore, the pooled Fisher's z values (pooled Fisher's z=0.36, 95% CI: 0.26-0.46, p<0.01) showed that there was a positive correlation between the serum IL-6 levels and SLE activity. This study suggested that serum IL-6 levels were higher in patients with SLE than in healthy controls, and they were positively correlated with disease activity when Systemic Lupus Erythematosus Disease Activity Index>4 was defined as active SLE. More homogeneous studies with large sample sizes are warranted to confirm our findings due to several limitations in our meta-analysis.

Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1.. Flow chart of the selection…
Figure 1.. Flow chart of the selection process for eligible studies.
Figure 2.. Meta-analysis comparing the serum IL-6…
Figure 2.. Meta-analysis comparing the serum IL-6 levels in SLE patients and healthy controls.
Figure 3.. Meta-analysis comparing the serum IL-6…
Figure 3.. Meta-analysis comparing the serum IL-6 levels in active SLE patients and inactive SLE patients.
Figure 4.. Meta-analysis of the correlation between…
Figure 4.. Meta-analysis of the correlation between the serum IL-6 level and SLE activity.
Figure 5.. Sensitivity analysis for the pooled…
Figure 5.. Sensitivity analysis for the pooled results of differences between the serum IL-6 levels in SLE patients and healthy controls (A); Sensitivity analysis for the pooled results of the differences between the serum IL-6 level in active SLE patients and inactive SLE patients (B); Sensitivity analysis for the pooled results of the correlation between the serum IL-6 level and SLE activity (C).
Figure 6.. Funnel plot of the pooled…
Figure 6.. Funnel plot of the pooled results of differences between serum IL-6 levels in SLE patients and healthy controls (A); The adjusted funnel plot of the pooled results of differences between serum IL-6 levels in SLE patients and healthy controls (B); Funnel plot of the pooled results of the correlation between the serum IL-6 level and SLE activity (C); The adjusted funnel plot of the pooled results of the correlation between the serum IL-6 level and SLE activity (D).

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