Optimal BMI cut-offs associated with cardiometabolic risks in Arab and Middle Eastern populations: a systematic review and meta-analysis.

BACKGROUND

The global rise in obesity has prompted the need to explore population-specific Body Mass Index (BMI) thresholds. Current international guidelines may not reflect the cardiometabolic risks in Arab and Middle Eastern populations. This systematic review and meta-analysis aim to identify optimal BMI cut-offs associated with cardiometabolic morbidity and mortality in these populations.

METHODS

A systematic search of Medline and Embase databases identified observational and experimental studies focusing on BMI thresholds linked to cardiometabolic outcomes, including Diabetes Mellitus (DM), hypertension (HTN), dyslipidemia (DLP), cardiovascular diseases (CVD), and metabolic syndrome. Data extraction followed PRISMA guidelines, and random-effects models were used to calculate pooled estimates of optimal BMI cut-offs. Subgroup and sensitivity analyses were performed to address heterogeneity.

RESULTS

Fifty-five studies involving 677,587 participants met the inclusion criteria. Optimal BMI cut-offs ranged from 26.22 to 27.45 kg/m². For DM, the BMI threshold was 27.39 kg/m² (95% CI: 26.70-28.09), while HTN and MetS were associated with thresholds of 27.00 kg/m² and 27.45 kg/m², respectively. Gender differences were observed, with females showing higher BMI cut-offs than males. The sensitivity and specificity of these cut-offs were moderate, with high between-study heterogeneity (I² > 90%). Publication bias was minimal for most outcomes, except DLP.

CONCLUSION

This study demonstrates that lower BMI thresholds are associated with cardiometabolic risks in Arab and Middle Eastern populations compared to global reports. Findings support the need for region-specific BMI cut-off guidelines and public health interventions targeting early diagnosis and management.