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

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 I2 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.