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BMI and Multimorbidity Risk: A Dose-response Meta-analysis and Systematic
Review of 43 Observational Studies with 94,978 Multimorbidity among 969,130
Participants

1
1
J. Shan, R. Yin, and S. Panuthai 1
1 Faculty of Nursing, Chiang Mai University, Thailand

Background: Multimorbidity is of paramount public health concern. It is particularly important to stop
multimorbidity effectively or to restrict its progression. However, we know little about the precautionary
measures of multimorbidity, but stay focusing on psychosocial status and behavioral elements,
especially population level interventions, such as fighting obesity, is likely to be beneficial.

Objective: To verify the dose-response relationship between the degree of BMI (body mass index) and
multimorbidity.

Methods: PubMed, CINAHL, and Embase are systematically studied until January 25, 2023. All original
articles in obesity based on classification of BMI and the risk of multimorbidity were included. Random
effects model and dose-response meta-analysis are used to estimate the OR (the pooled odds ratio)
with 95% CI (confidence interval). Sensitivity and subgroup analysis, and publication bias are
performed to explore potential heterogeneity in meta-analysis.

Results: Totally of 43 studies involving 969,130 patients (94,978 with multimorbidity) are involved in
the meta-analysis. Compared to being a normal BMI, being overweight is much similar with 1.37 times
possibility of getting multimorbidity; in persons with obesity level ।, obesity level ॥, and obesity level
।॥, the risk is 2.01, 2.31, and 3.82 times higher, respectively; and the risk decreased 0.86 times among
underweight persons. Additionally, obesity is 1.83 times as likely to be multimorbidity than those
Oral Presentation Abstracts
non-obese persons. Dose response analysis found the linear connection between the risk of
multimorbidity (Pnon-linearity=0.762) and BMI, that for each 1 kg/m2 and 5 kg/m2 augment in BMI, the
risk of multimorbidity increased by 6% and 35%. Subgroup analysis does not find the internal sources
of heterogeneity.

Conclusion: Multimorbidity increased linearly with an increase in BMI. Clinicians should pay attention
to the populations with abnormal weight, to help them control BMI to normal level. This could be an
important target for preventing multimorbidity, avoiding the complexity of multi-target prevention
programs.

Keywords: BMI, multimorbidity, obesity, overweight, dose-response meta-analysis

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Correspondence: Sirirat Panuthai, Faculty of Nursing, Chiang Mai University, Thailand
E-mail: sirirat.panuthai@cmu.ac.th

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