scholarly journals Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Susanna C. Larsson ◽  
Stephen Burgess

Abstract Background Obesity is a worldwide epidemic that has been associated with a plurality of diseases in observational studies. The aim of this study was to summarize the evidence from Mendelian randomization (MR) studies of the association between body mass index (BMI) and chronic diseases. Methods PubMed and Embase were searched for MR studies on adult BMI in relation to major chronic diseases, including diabetes mellitus; diseases of the circulatory, respiratory, digestive, musculoskeletal, and nervous systems; and neoplasms. A meta-analysis was performed for each disease by using results from published MR studies and corresponding de novo analyses based on summary-level genetic data from the FinnGen consortium (n = 218,792 individuals). Results In a meta-analysis of results from published MR studies and de novo analyses of the FinnGen consortium, genetically predicted higher BMI was associated with increased risk of type 2 diabetes mellitus, 14 circulatory disease outcomes, asthma, chronic obstructive pulmonary disease, five digestive system diseases, three musculoskeletal system diseases, and multiple sclerosis as well as cancers of the digestive system (six cancer sites), uterus, kidney, and bladder. In contrast, genetically predicted higher adult BMI was associated with a decreased risk of Dupuytren’s disease, osteoporosis, and breast, prostate, and non-melanoma cancer, and not associated with Alzheimer’s disease, amyotrophic lateral sclerosis, or Parkinson’s disease. Conclusions The totality of the evidence from MR studies supports a causal role of excess adiposity in a plurality of chronic diseases. Hence, continued efforts to reduce the prevalence of overweight and obesity are a major public health goal.

2018 ◽  
Author(s):  
Kaitlin H Wade ◽  
David Carslake ◽  
Naveed Sattar ◽  
George Davey Smith ◽  
Nicholas J Timpson

AbstractObjectiveObtain estimates of the causal relationship between different levels of body mass index (BMI) and mortality.MethodsMendelian randomization (MR) was conducted using genotypic variation reliably associated with BMI to test the causal effect of increasing BMI on all-cause and cause-specific mortality in participants of White British ancestry in UK Biobank.ResultsMR analyses supported existing evidence for a causal association between higher levels of BMI and greater risk of all-cause mortality (hazard ratio (HR) per 1kg/m2: 1.02; 95% CI: 0.97,1.06) and mortality from cardiovascular diseases (HR: 1.12; 95% CI: 1.02, 1.23), specifically coronary heart disease (HR: 1.19; 95% CI: 1.05, 1.35) and those other than stroke/aortic aneurysm (HR: 1.13; 95% CI: 0.93, 1.38), stomach cancer (HR: 1.30; 95% CI: 0.91, 1.86) and oesophageal cancer (HR: 1.08; 95% CI: 0.84, 1.38), and with decreased risk of lung cancer mortality (HR: 0.97; 95% CI: 0.84, 1.11). Sex-stratified analyses supported a causal role of higher BMI in increasing the risk of mortality from bladder cancer in males and other causes in females, but in decreasing the risk of respiratory disease mortality in males. The characteristic J-shaped observational association between BMI and mortality was visible with MR analyses but with a smaller value of BMI at which mortality risk was lowest and apparently flatter over a larger range of BMI.ConclusionResults support a causal role of higher BMI in increasing the risk of all-cause mortality and mortality from other causes. However, studies with greater numbers of deaths are needed to confirm the current findings.


2020 ◽  
Vol 49 (4) ◽  
pp. 1236-1245 ◽  
Author(s):  
Jean Claude Dusingize ◽  
Catherine M Olsen ◽  
Jiyuan An ◽  
Nirmala Pandeya ◽  
Matthew H Law ◽  
...  

Abstract Background Height and body mass index (BMI) have both been positively associated with melanoma risk, although findings for BMI have been less consistent than height. It remains unclear, however, whether these associations reflect causality or are due to residual confounding by environmental and lifestyle risk factors. We re-evaluated these associations using a two-sample Mendelian randomization (MR) approach. Methods We identified single nucleotide polymorphisms (SNPs) for BMI and height from separate genome-wide association study (GWAS) meta-analyses. We obtained melanoma SNPs from the most recent melanoma GWAS meta-analysis comprising 12 874 cases and 23 203 controls. We used the inverse variance-weighted estimator to derive separate causal risk estimates across all SNP instruments for BMI and height. Results Based on the combined estimate derived from 730 SNPs for BMI, we found no evidence of an association between genetically predicted BMI and melanoma [odds ratio (OR) per one standard deviation (1 SD) (4.6 kg/m2) increase in BMI 1.00, 95% confidence interval (CI): 0.91–1.11]. In contrast, we observed a positive association between genetically-predicted height (derived from a pooled estimate of 3290 SNPs) and melanoma risk [OR 1.08, 95% CI: 1.02–1.13, per 1 SD (9.27 cm) increase in height]. Sensitivity analyses using two alternative MR methods yielded similar results. Conclusions These findings provide no evidence for a causal association between higher BMI and melanoma, but support the notion that height is causally associated with melanoma risk. Mechanisms through which height influences melanoma risk remain unclear, and it remains possible that the effect could be mediated through diverse pathways including growth factors and even socioeconomic status.


2015 ◽  
Vol 64 (5) ◽  
pp. 87-95 ◽  
Author(s):  
Roman Victorovich Kapustin ◽  
Ol’ga Nikolaevna Arzhanova ◽  
Olesya Nikolaevna Bespalova ◽  
Vladimir Stepanovich Pakin ◽  
Andrey Gennadievich Kiselev

Objective: on the basis of a systematic review, clarify the role of overweight and obesity as a predictor of gestational diabetes mellitus (GDM). Materials and methods: an analysis of the literature data of the leading bibliographic sources - MEDLINE, Cochrane col., EMBASE. To evaluate the body mass index and standards of weight gain during pregnancy used the WHO guidelines and criteria of the Institute of Medicine (2009). The frequency and the odds ratio (OR) of developing GDM was estimated separately for each of the three groups in BMI. Results: A systematic review included 23 different design studies involving 740 510 women. It was found that the odds ratio of the risk of GDM in a group of pregnant women with excess weight is doubled - 2.22 (95 % CI 1.72 - 3.64), and almost four in obesity - 3.88 (95 % CI 2.97 - 5.32). The incidence of GDM in a group of pregnant women with normal body mass index - 3.77 % in the group with excess body weight - 6.59 %, in the group with obesity - 9.88 %. Conclusions: The obtained strong evidence of a direct connection between the linear increase in maternal BMI and the risk of developing gestational diabetes. Pregnant women with excess weight and obesity are at high risk for carbohydrate disorders during pregnancy.


2020 ◽  
Author(s):  
Audinga-Dea Hazewinkel ◽  
Padraig Dixon ◽  
Rebecca Richmond ◽  
Kaitlin H Wade

Background Body mass index (BMI) and waist-hip-ratio (WHR) are measures of adiposity, the former being a good marker for overall total body fat, the latter describing regional adiposity. Higher adiposity has been associated with the increased prevalence of many chronic diseases and a positive association between BMI and increased hospital admissions has previously been established. The aim of this study was to estimate the causal relationship between BMI, WHR and WHR adjusted for BMI (WHRadjBMI) and yearly hospital admission rates. Methods and Findings Mendelian randomization (MR) approaches were used to test the causal effect of BMI, WHR and WHRadjBMI on yearly hospital admission rates. Using data on 310,471 participants of White-British ancestry from the UK Biobank, we performed one-sample and two-sample MR analyses on the exposures individually and in a multivariable setting. MR analyses supported a causal role of adiposity on hospital admissions, with consistency across one- and two-sample MR methods. Primarily, one-sample MR analyses estimated fold-increases in yearly hospital admission rates of 1.13 (95% CI: 1.02, 1.27), 1.26 (95% CI: 1.00, 1.58) and 1.22 (95% CI: 1.01, 1.47) per SD for BMI, WHR and WHRadjBMI, respectively. A multivariable approach yielded estimates of 1.04 (95% CI: 0.99, 1.03) for BMI and 1.31 (95% CI: 1.04, 1.67) for WHR, while adjusting for WHR and BMI, respectively. Conclusions The results support a causal role of higher BMI and WHR in increasing the yearly hospital admission rate. The attenuation of the BMI effect, when adjusting for WHR in the multivariable MR analyses, suggested that an adverse fat distribution, rather than a higher BMI itself, may drive the relationship between adiposity and increased risk of hospital admission. Keywords: Body mass index (BMI), waist-hip-ratio (WHR), hospital admission, Mendelian randomization


2019 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem

AbstractBackgroundMortality and morbidity in patients with diabetes mellitus (DM) is attributed to both the micro-vascular and macro-vascular complications. Variation among primary studies was seen on the prevalence of erectile dysfunction in Africa. Therefore, this study was aimed to estimate the pooled prevalence of erectile dysfunction patients with diabetes mellitus and its association with body mass index and glycated hemoglobin in Africa.MethodsPubMed, Web of Science, Cochrane library, Scopus, Psyinfo, Africa online journal and Google Scholar were searched. A funnel plot and Egger’s regression test were used to see publication bias. I-squared statistic was used to check heterogeneity of studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and Meta regression analysis were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of single study on the overall estimation. STATA version 14 statistical software was used for meta-analysis.ResultA total of 20 studies with 5,177 study participants were included to estimate the pooled prevalence. The pooled prevalence of erectile dysfunction patients with diabetes mellitus was 61.62% (95% CI: 48.35–74.9). BMI ≥ 30kg/m2 (AOR = 1.26; 95% CI: 0.73 –2.16), and glycated hemoglobin ≥ 7% (AOR = 0.93; 95% CI: 0.5–5.9), were identified factors though not statistically significant associated with erectile dysfunction.ConclusionsThe prevalence of erectile dysfunction in Africa remains high. Therefore, situation based interventions and country context specific preventive strategies could be developed to reduce the magnitude of erectile dysfunction among patients with diabetes mellitus.


2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e15559-e15559
Author(s):  
Sashidhar Manthravadi ◽  
Anuj Shrestha ◽  
Sheshadri Madhusudhana

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Wondimeneh Shibabaw Shiferaw ◽  
Tadesse Yirga Akalu ◽  
Yared Asmare Aynalem

Background. Mortality and morbidity in patients with diabetes mellitus (DM) are attributed to both microvascular and macrovascular complications. However, there is a significant amount of variation in the primary studies on DM regarding the prevalence of erectile dysfunction (ED) in Africa. Therefore, this study was aimed to estimate the pooled prevalence of ED patients with DM and its association with body mass index (BMI) and glycated hemoglobin in Africa. Methods. PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were searched for studies that looked at ED in DM patients. A funnel plot and Egger’s regression test were used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. The subgroup and meta-regression analyses were conducted by country, sample size, and year of publication. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. STATA version 14 statistical software was used for the meta-analysis. Result. A total of 13 studies with 3,501 study participants were included in this study. We estimated that the pooled prevalence of ED in patients with DM in Africa was 71.45% (95% CI: 60.22–82.69). Diabetic patients whose BMI was ≥30 kg/m2 were 1.26 times more likely to develop ED (AOR = 1.26; 95% CI: 0.73–2.16) and whose glycated hemoglobin was <7% were 7% less likely to develop ED (AOR = 0.93; 95% CI: 0.5–5.9), although they were not significantly associated with ED. Conclusions. The prevalence of ED in DM patients in Africa remains high. Therefore, situation-based interventions and country context-specific preventive strategies should be developed to reduce the prevalence of ED among patients with DM.


2019 ◽  
Vol 25 (3-4) ◽  
pp. 74-79 ◽  
Author(s):  
Sumanta Saha ◽  
Sujata Saha

<b><i>Aims:</i></b> To date, it is largely unknown how body mass index (BMI), gestational weight (GW), and stored vitamin D (25(OH)D) levels change in the vitamin D-supplemented gestational diabetes mellitus (GDM) patients, irrespective of their pre-pregnancy BMI. Therefore, to study this association, a prospective systematic review and meta-analysis protocol is proposed here. <b><i>Methods:</i></b> Primarily, different databases (PubMed, Embase and Scopus) will be searched (without any limitation to date or language) for randomised parallel-arm trials comparing GW, BMI and stored vitamin D level in the body among GDM patients who were supplemented and not supplemented with vitamin D, besides their conventional GDM care. The study selection process and the consecutive risk of bias assessment will adhere to the PRISMA 2009 flow chart and the Cochrane collaboration’s guideline, respectively. These interventions’ effect on the respective outcomes will be compared by meta-analysis (along with an assessment of the statistical heterogeneity) when comparable data will be available from at least 4 studies. Subgroup analysis and Egger’s meta-regression will follow if an adequate number of trials are available. Narrative reporting will be considered when a quantitative comparison is not feasible for any of the outcomes. <b><i>Conclusion:</i></b> The proposed review aims to compare the BMI, GW, and 25(OH)D levels in the blood between the vitamin D supplemented and not supplemented GDM patients.


Sign in / Sign up

Export Citation Format

Share Document