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Meta-Analysis
. 2021 Dec 15;19(1):320.
doi: 10.1186/s12916-021-02188-x.

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

Susanna C Larsson  1   2 , Stephen Burgess  3   4
Affiliations
Meta-Analysis

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

Susanna C Larsson et al. BMC Med. .

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.

Keywords: Body mass index; Cancer; Cardiovascular disease; Chronic diseases; Obesity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study selection
Fig. 2
Fig. 2
Meta-analysis results for genetically predicted BMI in relation to diseases of the circulatory system. Results are scaled per 1 SD increase of BMI. Analyses of coronary artery disease and peripheral artery disease include individuals of both European (the vast majority) and non-European ancestry; analyses of other outcomes include individuals of European ancestry only
Fig. 3
Fig. 3
Meta-analysis results for genetically predicted BMI in relation to diseases of the digestive system. Results are scaled per 1 SD increase of BMI. All analyses include individuals of European ancestry only. GERD gastroesophageal reflux disease, NA not available, NAFLD nonalcoholic fatty liver disease
Fig. 4
Fig. 4
Meta-analysis results for genetically predicted BMI in relation to neoplasms. Results are scaled per 1 SD increase of BMI. Analyses include individuals of European ancestry only if not otherwise indicated (i.e., trans-ancestry). NA not available
See this image and copyright information in PMC

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