Impact of body mass index on mortality rates in tuberculosis: A systematic review and meta-analysis

  • Yichen Li
  • Jie Cheng
  • Xinxin Bai
  • Jie Zheng
  • Peifang Mao
  • Xiuzhi Zhou Wenzhou Central Hospital, Nanbaek Elephant Hospital
Keywords: Malnourished, Nutrition, Underweight, Obese, Tuberculosis, Death, Malnutrition, Obesity, Mortality

Abstract

Objective: To decipher the role of body mass index (BMI) measured at treatment initiation on mortality rates in tuberculosis (TB).

Methods: This PROSPERO-registered PRISMA compliant review searched PubMed, Embase, CENTRAL, and Web of Science for studies from inception upto 10th June 2024. Studies on adult patients examining mortality rates in TB patients based on BMI at treatment initiation were included. We analyzed crude and adjusted mortality rates in a random-effects meta-analysis model. Data was pooled to generate odds ratio (OR) and 95% confidence intervals (CI).

Results: Ten studies were included. Both crude (OR: 2.54 95% CI: 2.13, 3.03 I2=56%) and adjusted (OR: 1.99 95% CI: 1.63, 2.44 I2=68%) data analysis showed that low BMI (<18.5 kg/m2) at treatment initiation was a significant factor increasing mortality rates of TB. Meta-analysis of crude data (OR: 1.07 95% CI: 0.68, 1.69 I2=76%) did not demonstrate a significant association between high BMI and mortality, but adjusted data showed that high BMI was associated with significantly reduced risk of mortality in TB patients (OR: 0.79 95% CI: 0.66, 0.95 I2=10%).

Conclusions: Low BMI is associated with a significantly increased risk of mortality in TB patients. Scarce evidence also suggests that a high BMI may offer better survival rates for TB.

Registration No.: PROSPERO (CRD42023494176).

doi: https://doi.org/10.12669/pjms.41.6.11722

How to cite this: Li Y, Cheng J, Bai X, Zheng J, Mao P, Zhou X. Impact of body mass index on mortality rates in tuberculosis: A systematic review and meta-analysis. Pak J Med Sci. 2025;41(6):1836-1844. doi: https://doi.org/10.12669/pjms.41.6.11722

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2025-06-03
How to Cite
Li, Y., Cheng, J., Bai, X., Zheng, J., Mao, P., & Zhou, X. (2025). Impact of body mass index on mortality rates in tuberculosis: A systematic review and meta-analysis. Pakistan Journal of Medical Sciences, 41(6), 1836-1844. https://doi.org/10.12669/pjms.41.6.11722
Section
Systematic Review