Early Atherosclerosis in Pediatric Systemic Lupus Erythematosus: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
OBJECTIVE: Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. Numerous meta-analyses in adults with SLE have consistently demonstrated altered surrogate parameters of atherosclerosis (subclinical atherosclerosis). However, meta-analyses assessing the impact of pediatric SLE (pSLE) on cardiovascular health are lacking. Herein, we perform a systematic review and meta-analysis of studies assessing subclinical atherosclerosis in pSLE. METHODS: Embase, Web of Science, and PubMed databases were systematically searched for pertinent literature published between January 1965 and February 2024. Patients with SLE and healthy participants were included as cases and controls, respectively. Online PICO portal, Newcastle-Ottawa scale, Review Manager and R software, and GRADEpro GDT tool were used for study deduplication and data extraction, study quality evaluation, data synthesis/analysis (including meta-regression), and certainty of evidence assessment, respectively. RESULTS: A total of 9 studies (out of 126 citations), including 1021 participants (528 cases and 493 controls), were included in the analysis. Carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) were significantly higher in cases as compared to controls [mean difference (MD) 0.04 (95% CI 0.01-0.08) mm, p = 0.007 and MD 0.48 (95% CI 0.02-0.94) m/s, p = 0.04, respectively]. The flow-mediated dilatation was similar in the two groups. Significant heterogeneity was observed for all the outcome measures. On meta-regression analysis, disease duration correlated significantly with both CIMT MD and PWV MD. CONCLUSIONS: A "low"-quality evidence suggests that pSLE may adversely impact vascular microanatomy and physiology. Longitudinal studies are needed to precisely quantify the cardiovascular risk in pSLE. REGISTRATION: PROSPERO (CRD42022323752).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.028 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.031 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".