Association of Abnormal Body Weight and Allergic Rhinitis—A Systematic Review and Meta-Analysis

Abstract

Objective: Allergic rhinitis (AR) is a prevalent inflammatory condition of the nasal mucosa, with significant burden worldwide. While studies have demonstrated a relationship between body mass index (BMI) and other atopic diseases, its association with AR is uncertain. This study aims to clarify the association between non-normal BMI and AR. Design: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, independent authors screened studies for eligibility, extracted data and assessed bias of included studies using the Newcastle–Ottawa scale and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. A random-effects meta-analysis was used to pool maximally covariate-adjusted estimates. Additional subgroup and bias analyses were performed. Data Sources: PubMed, Embase, Cochrane Library, SCOPUS and CINAHL were searched from inception to 14 January, 2024. Eligibility Criteria: Observational studies investigating the association between non-normal BMI and AR in both children and adults. Results: We included 32 articles comprising 2,008,835 participants. The risk of bias was low (N = 20) or moderate (N = 12) and GRADE certainty of evidence was very low to low. Pooled cross-sectional analyses indicated that obese children (OR = 0.99, 95% CI = 0.96–1.03, I2 = 0%), obese adults (OR = 1.11, 95% CI = 0.92–1.33, I2 = 73%), overweight children (OR = 1.02, 95% CI = 0.98–1.06, I2 = 35%), and overweight adults (OR = 1.13, 95% CI = 0.90–1.40, I2 = 0%) showed similar odds of AR compared to controls. Additionally, longitudinal analyses did not identify any evidence for an association between overweight (OR = 1.03, 95% CI = 0.85–1.24, I2 = 29%) or underweight (OR = 1.09, 95% CI = 0.77–1.54, I2 = 72%) children and AR risk. These results remained largely robust across various subgroups and sensitivity assessments. Conclusion: Abnormal BMI may not be associated with AR. This study adds to the expanding literature on the association between non-normal BMI and atopic diseases. Further prospective studies are needed to explore the longitudinal relationship between BMI and AR and the effect of weight loss interventions on AR, given the limits of existing literature. Trial Registration: PROSPERO CRD42024503589.