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

Abstract

<h4>Objective</h4>To decipher the role of body mass index (BMI) measured at treatment initiation on mortality rates in tuberculosis (TB).<h4>Methods</h4>This PROSPERO-registered PRISMA compliant review searched PubMed, Embase, CENTRAL, and Web of Science for studies from inception upto 10^th 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).<h4>Results</h4>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%).<h4>Conclusions</h4>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.