The Influence of Body Mass Index on Facial Soft Tissue Morphology in Growing Non-Obese Children: A Systematic Review and Meta-Analysis

Abstract

Background: Childhood obesity is a global health concern with known systemic effects, including potential influences on craniofacial growth. However, the specific relationship within the non-obese pediatric population, where variations in normal Body Mass Index (BMI) may also correlate with facial form, remains poorly synthesized. Objective: To systematically review and analyze the available evidence on the association between BMI (within the non-obese range) and facial soft tissue morphology in growing children. Data Sources: A systematic search of MEDLINE/PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library was conducted from inception to October 2023. Study Selection: Observational studies (cross-sectional, cohort, case-control) that evaluated the correlation between BMI (or BMI percentile) and quantifiable facial soft tissue measurements (e.g., linear, angular, area) in healthy, non-obese children and adolescents were included. Data Extraction: Two independent reviewers extracted data on study characteristics, population demographics, BMI metrics, facial measurement methods (e.g., 2D photography, 3D stereophotogrammetry), and statistical associations. Data Synthesis: Meta-analyses were performed where possible using random-effects models to calculate pooled correlation coefficients (r) for the relationship between BMI and key facial dimensions. Heterogeneity was assessed using the I² statistic.

Results: The search yielded 15 eligible studies. A moderate positive correlation was found between BMI and facial width, with a pooled correlation coefficient of r = 0.42 (95% CI: 0.35, 0.49; I²=68%). A weaker but significant positive correlation was observed for lower face height (r = 0.28, 95% CI: 0.18, 0.37; I²=55%). BMI was negatively correlated with the labiomental angle (r = -0.31, 95% CI: -0.41, -0.20; I²=45%), indicating a more obtuse angle with increasing BMI.
Conclusions: Even within the non-obese range, higher BMI in children is significantly associated with a broader, rounder facial phenotype with a less pronounced chin. These findings highlight the importance of considering weight status in orthodontic and craniofacial assessment.

Received Date: February 25, 2025                  

Accepted Date: March 18, 2025                   

Published Date: April 01, 2025

Available Online at https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/499