Correspondence on 'A Combination of Healthy Lifestyle Behaviors Reduces Risk of Incident Systemic Lupus Erythematosus ' by Choi et al.

We read with great interest the article of Choi et al investigating whether a combination of individual factors related to lifestyle is associated with the lower risk of incident SLE.[1] However, it is pity that residual confounders have not been adjusted. Firstly, we have found that the residual confounders such as endometriosis, infection and comorbidities are correlated with SLE. For example, a recent study has investigated that the risk of getting SLE in endometriosis patients is higher compared to general population, which shows an association between endometriosis and SLE.[2] Hence, with the majority of the female participants in the study, the occurrence of endometriosis is needed to be discussed.