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Association Between Obesity and CV Outcomes
Study Questions:
Do mendelian randomization studies support the association between obesity and cardiovascular outcomes observed in other types of studies?
Methods:
This meta-analysis used systematic searches of MEDLINE and Scopus (from database inception to January 2018) to identify studies which used body mass index as a measure of obesity to examine the association between obesity and cardiovascular events. All studies included used mendelian randomization methods. The primary outcomes were type 2 diabetes, coronary artery disease (CAD), and stroke.
Results:
A total of 4,660 articles were identified, from which 2,511 titles were screened. Of these titles, seven studies were included in the systematic review and five studies were included in the meta-analysis. These five studies included 881,692 participants with a mean age of 60 years. These studies adjusted for a mean of 47 single-nucleotide polymorphisms (range, 9-97). Obesity was significantly associated with an increased risk for type 2 diabetes (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.30-2.14; p < 0.001; I2 = 93%) in the pooled risk estimate. An association between CAD and obesity was also observed (OR, 1.20; 95% CI, 1.02-1.41; p = 0.03; I2 = 87%). However, no association between obesity and stroke was found (OR, 1.02; 95% CI, 0.95-1.09; p = 0.65; I2 = 0%).
Conclusions:
This meta-analysis suggests that obesity is associated with type 2 diabetes and CAD.
Perspective:
This meta-analysis and systematic review support the continued public health efforts to prevent and reduce overweight and obesity. Given the projected prevalence of obesity worldwide, continued research and policy efforts are greatly needed.
Keywords: Body Mass Index, Coronary Artery Disease, Diabetes Mellitus, Type 2, Metabolic Syndrome, Obesity, Overweight, Polymorphism, Single Nucleotide, Primary Prevention, Public Health, Risk, Stroke, Vascular Diseases
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