The Association between Body Mass Index and Metabolic Conditions

Research Article

J Fam Med. 2018; 5(2): 1138.

The Association between Body Mass Index and Metabolic Conditions

Khaled K Aldossari*

¹Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al- Kharj, Saudi Arabia

*Corresponding author: Khaled K. Aldossari, Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia

Received: March 04, 2018; Accepted: March 26, 2018; Published: April 03, 2018


Introduction: Obesity is one of the significant public health epidemic and its global prevalence is increasing. Along with this, certain risk factors including malnutrition, lack of physical activity and high stress levels contribute to the emergence of various other metabolic conditions that may cluster together in enhancing the effects of obesity and might hinder in its control.

Methods: This is a cross sectional study in which chart review of patients’ files for all patients coming to the outpatients department (OPD) clinic in Prince Sattam bin Abdul-Aziz University, Alkharj, Saudi Arabia until the sample size i.e. 354 was achieved. Data was analysed with SPSS version 21. Descriptive statistics were obtained as frequencies. Pearson Chi-square analysis was used to assess any differences between Body Mass Index (BMI) categories and study variables. The logistic regression model was used to examine the relationship between BMI categories and potential causal factors at p-value‹0.05 which was considered significant.

Results: Findings showed that 45.8% of study population was obese, 28.5% was overweight Gender distribution showed that highest number of females i.e. 47.2% were obese followed by overweight (28.8%). Similar trend was found among males i.e. 35.6% and 26.7% respectively. Across various BMI categories, individuals between 16-30 years were healthy; 16-45 years were obese and overweight. Among all, 11% were found to be hypertensive, 45.5% anemic while 58% had vitamin D deficiency. Hypertension was prevalent in 17.4% of obese whereas anemia remained constant in all BMI categories. Likewise, vitamin D deficiency was evident in obese (63.4%), healthy (65.5%) and underweight (54.5%). Chi square showed age groups, Vitamin D deficiency and hypertension to be the significant predictors of BMI however, logistic regression showed no significant association.

Conclusion: The present study showed no significant association between BMI categories and anemia, vitamin D deficiency, hypertension along various age groups; indicating that there might be other causes in Saudi population causing. Longitudinal and interventional studies are required to prove this association incorporating factors like socio-demographics, diet and exercise. Strategies should be build up to minimize the prevalence of such preventable conditions under discussion in order to promote better health among Saudi population.

Keywords: Obesity; Anemia; Vitamin D deficiency; Hypertension


Obesity is one of the significant public health issues nowadays and its global prevalence has turned into an epidemic. It can be defined as excessive body fat [1], whichaffected approximately one third of the population worldwide. It was reported to cause greater than 2.8 million deaths i.e. 4% Years of Life Lost (YLL) and around 35.8 million Disability-Adjusted Life Years (DALYs) [2]. Estimations show that if such trend continues, by 2030, 85% of the people living in US will be affected by it [3] while 20% of the total population of the world will be obese and 38% will be overweight [4]. Significant declined life expectancy was also reported in obese individuals as compared to non-obese [5].

Contribution of obesity towards increased risks of non-communicable diseases (NCDs) is well documented; despite being a preventable and modifiable risk factor, it is reported to cause metabolic syndrome [6], dyslipidemia [7] hypertension, heart diseases [8], insulin resistance, glucose intolerance [9]. ischemic stroke [5], asthmatic emergencies [10], Obstructive sleep Apnea [11], vitamin D deficiency [12], cholelithiasis and gastroesophageal reflux disease [13] polycystic ovarian syndrome in females, osteoarthritis, various psychiatric illnesses and cancers [14], and also impotence as well as infertility in men [15]. The third National Health and Nutrition Examination Survey (NHANES III) showed overweight American children [16] and adults [17] to have iron deficiency anemia while Chinese did not had this association [18].

Recent statistics show that 5-14% of the people living in gulf region including Saudi Arabia, Qatar, Oman, Kuwait, Bahrain, Lebanon and United Arab Emirates were obese [19]. Data from Saudi Arabia reveals that 66% men and 71% women were overweight whereas 28% males and 44% females were obese. Similar situation was with Kuwaiti population where 36% men and 48% females were obese while 74% men and 77% women were overweight [20]. Etaiwi et al, concluded that Obesity was significantly associated with an augmented incidence of hypertension and its complications [21]. The prevalence of obesity and vitamin D deficiency is high in Saudi Arabia [22,23] but their association was not established in a sample of females from Jeddah [24]. However, obese children were foundat risk of developing vitamin D deficiency [25].

The World Health Organization (WHO) has implemented a parameter called body mass index (BMI) scale, to measure obesity. This can be attained by dividing the total body weight n kilograms by the square of the height taken in meters [7]. Considering this, obesity can be confirmed with BMI value of =30Kg/m2. An increased risk for co-morbidities was declared by WHO between the BMI of 25.0 and 29.9 whereas moderate to severe risk exists when it is >30 [2] BMI can be altered by various determinants that can be genetic or environmental. For instance, female gender, education, occupation, marital status, physical activity, dietary habits, presence of NCDs etc. [20,26].

A study from the eastern province of Saudi Arabia found 43.8% overall prevalence of obesity with peak in the age group 50-59 years being higher among females; significantly in housewives and less educated [27] in Western regions, it was 10% while in Eastern it was 14%including Jizan (12%), Hail (34%) and Riyadh (22%) pertaining to more fast food utilization and sedentary lifestyle [28] and high Income [29]. Taking into account the current situation of Saudi Arabia and the high prevalence of obesity, vitamin D deficiency, anemia and hypertension among different age groups and across both genders [21-23,30], we aim to study the association between various BMI categories and certain metabolic conditions including anemia, Vitamin D deficiency and hypertension.

Materials and Methods

The cross sectional study was the selected for the design for the study.All the patients who came to the outpatient clinic from 1st August to 30 November 2016 were selected until the sample size was achieved. The study was conducted in the University hospital of Prince Sattam bin Abdul-Aziz University, Al Kharj, Saudi Arabia. Given that prevalence of obesity (35.5) and overweight (36.9) in Saudi Arabia according to study done in Jeddah [31] and the total population of Al Kharj governorate is 376325 [32], by using raosoft. com website the sample size was calculated using Open Epi sample size calculator keeping confidence level at 95% and margin of error at 5%, the total sample would be 354. Based on thorough review of relevant literature, the researchers constructed a chart review of patient files including age, presence of metabolic conditions as shown by blood tests and anthropometric measurements i.e. body weight (in kilograms), height (in meters) and then body mass index (BMI) was calculated.

Data collection

We conducted the following tests to find any association between BMI categories and anaemia, vitamin D deficiency and age groups (Table 1).