Sex-related associations between body mass index and the incidence of epilepsy

Abstract

BackgroundThe aim of this study was to investigate the association between both overweight and underweight and epilepsy in adult individuals using a large German database. MethodsThis retrospective cohort study was based on data from the Disease Analyzer database (IQVIA) and included patients with documented body mass index (BMI) values followed up in one of 832 general practices in Germany between January 2006 and December 2019. The association between BMI categories and the 10-year incidence of epilepsy was studied separately for women and men using Cox regression models adjusted for age and comorbidities. ResultsThis study included 822,071 patients. The proportions of underweight, normal weight, overweight, and obesity were 1.6%, 33.4%, 36.7%, and 28.3% respectively.Underweight was significantly and positively associated with the incidence of epilepsy (HR = 1.67, 95% CI = 1.31–2.11) compared to normal weight. This association was much stronger in men (HR = 2.57, 95% CI = 1.71–3.88) than in women (HR = 1.48, 95% CI = 1.10–1.98). However, underweight was significantly associated with an increased risk of generalized epilepsy only (HR: 4.38; 95% CI: 1.34–14.35), but no significant associations between weight and the incidence of focal epilepsy was observed. ConclusionIn conclusion, a significant and positive association between underweight and generalized and unclassified epilepsy was observed, which was stronger in men than in women. Further studies are needed to confirm these results and find the reasons for this association.