title: Association between body mass index and prevalence of multimorbidity: a cross-sectional study.
abstract: OBJECTIVE
  To explore the prevalence of multimorbidity in Serbia according to sex and body mass index (BMI) categories, and to examine the association between BMI and multimorbidity. In addition, this study examined the relationships between the main demographic and socio-economic characteristics of the population (age, settlement, education) and multimorbidity.
  
  
  METHODS
  Secondary analysis of data from the 2013 Serbian National Health Survey.
  
  
  METHODS
  This study analyzed data from 13,103 participants aged ≥20 years with BMI data. The associations between BMI, age, education and multimorbidity were analyzed by multivariate logistic regression.
  
  
  RESULTS
  The overall prevalence of multimorbidity was higher than the overall prevalence of a single disease (26.9% vs 20.7%). The proportion of participants who reported two or more chronic diseases increased with each BMI category in both sexes, reaching the highest values in obese category III. Odds ratios (ORs) for the prevalence in all morbidity groups increased gradually with BMI category, and the highest OR values were found in obese category III. Males of obese category III were seven times more likely to have multimorbidity [OR 7.2, 95% confidence interval (CI) 4.2-12.6] than males of normal weight, whereas females of obese category III were nine and a half times more likely to have multimorbidity (OR 9.5, 95% CI 4.0-22.4) than females of normal weight. In the multivariable analysis, age (both sexes), low and middle level of education (males), and rural settlement and low level of education (females) were found to be predictors of multimorbidity.
  
  
  CONCLUSIONS
  This study found positive associations between obesity and multimorbidity and between overweight and multimorbidity. Recognizing these associations is of great importance from both clinical and public health perspectives because this could lead to an integrated approach for patients.
authors.affiliation: Institute of Public Health of Serbia, Centre for Hygiene and Human Ecology, Belgrade, Serbia. Electronic address: drdraganajovic@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Jovic
authors.affiliation: Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, Belgrade, Serbia.
authors.forename: J
authors.initials: J
authors.lastname: Marinkovic
authors.affiliation: Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: D
authors.initials: D
authors.lastname: Vukovic
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D055771:Serbia / Q000453:epidemiology; D017678:Sex Distribution; D055815:Young Adult
keywords: BMI; Cross-sectional study; Multimorbidity; Serbia