ICJIM
Intercontinental Journal of Internal Medicine

The Intercontinental Journal of Internal Medicine aims to publish issues related to all fields of internal medicine of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
U-shaped relationship between BMI and cardiometabolic risk: a six-group cross-sectional study
Abstract
Aims: Body mass index (BMI) is a major determinant of cardiometabolic risk, yet the risk patterns in both low and high BMI categories remain incompletely characterized. This study aimed to investigate cardiometabolic risk markers across six BMI-based groups and to identify independent predictors of risk.
Methods: A total of 120 participants were stratified into six BMI groups. Anthropometric measurements, blood pressure, and laboratory parameters, including hsCRP, lipid profile, fasting glucose, insulin, HOMA-IR, and complete blood count, were collected. Comparisons among groups were performed using one-way ANOVA or Kruskal–Wallis tests as appropriate. Pearson or Spearman correlation analyses assessed associations between hsCRP and other laboratory markers. Multinomial logistic regression was used to identify independent predictors of group status, with BMI groups collapsed into three categories for model stability.
Results: Age and height did not differ significantly among BMI groups, while body weight and waist circumference differed as expected (p<0.001). hsCRP demonstrated a U-shaped association across BMI groups, with the lowest levels in the moderate BMI range and elevated levels observed in both the lowest and highest BMI groups. Correlation analyses revealed significant positive associations of hsCRP with triglycerides, TG/HDL ratio, fasting insulin, HOMA-IR, and MPV (all p<0.001). Multinomial logistic regression confirmed hsCRP as an independent predictor of BMI group status (p=0.001).
Conclusion: Cardiometabolic risk markers exhibit a non-linear, U-shaped relationship with BMI. Importantly, elevated risk was detected not only in the high BMI groups but also in participants with low BMI, which emphasizes the need to consider underweight individuals in cardiometabolic risk assessment. hsCRP emerged as a robust independent predictor of BMI-associated risk, reinforcing its potential role in early detection strategies.

Keywords : Body-mass index, cardiometabolic risk, high-sensitivity C-reactive protein (hsCRP), underweight, obesity

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Article available in :
Volume 4, Issue 1, 2026
Page : 13-21
https://doi.org/10.51271/ICJIM-0069
Article Information
Received : 23 Oca 2026
Accepted : 27 Şub 2026
Published : 28 Şub 2026
Corresponding Author :

Aykut Hacıömeroğlu: Department of Internal Medicine, Eskipazar Hospital, Karabük, Turkiye

[email protected]
Citation : Hacıömeroğlu A, Çifci A. U-shaped relationship between BMI and cardiometabolic risk: a six-group cross-sectional study. Intercont J Int Med. 2026;4(1):13-21.

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