Body mass index and risk of clostridioides difficile infection: a systematic review and meta-analysis.

Nipith Charoenngam, Ben Ponvilawan, Jerapas Thongpiya, Pitchaporn Yingchoncharoen, Thanat Chaikijurajai, Natapat Chaisidhivej, Caroline M Apovian, Patompong Ungprasert

Journal: Infection 2022;50(3):725-737

PMID: 34985688

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Abstract

OBJECTIVE

To comprehensively investigate the association between obesity/high body mass index (BMI) and risk of Clostridioides difficile infection (CDI) using systematic review and meta-analysis.

METHODS

Potentially eligible studies were identified from Medline and EMBASE databases from inception to February 2021 using search strategy consisting of terms for "Body Mass Index" and "Clostridioides Difficile". We only included studies that consist of a group of individuals with CDI and another group without CDI. Then, the studies must report their BMI or history of obesity. Odds ratio (OR) and 95% CIs of the association between BMI status and CDI were retrieved from each study and combined using the generic inverse variance method. Funnel plot was used to assess publication bias.

RESULTS

A total of 4609 articles were identified. After two rounds of systematic review, 17 studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that individuals with high BMI had a significantly decreased odds of CDI with the pooled OR of 0.88 (95% CI 0.80-0.97). This meta-analysis had high statistical heterogeneity with I of 74%. Funnel plot was symmetric, which was not suggestive of presence of publication bias.

CONCLUSION

This meta-analysis revealed a significant negative association between BMI and CDI.

Address: Department of Medicine, Mount Auburn Hospital, Harvard Medical School, 330 Mt Auburn St, Cambridge, MA, 02138, USA. [email protected].; Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA, 02118, USA. [email protected].; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. [email protected].; Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Department of Medicine, University of Minnesota, Twin Cities, Minneapolis, MN, USA.; Department of Medicine, Einstein Medical Center Philadelphia, Philadelphia, PA, USA.; Section of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.; Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, OH, USA.

DOI: 10.1007/s15010-021-01749-9

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https://doi.org/10.1007/s15010-021-01749-9

MeSH Terms: Body Mass Index, Clostridium Infections, Humans, Obesity, Odds Ratio