Birmann Brenda M, Andreotti Gabriella, De Roos Anneclaire J, Camp Nicola J, Chiu Brian C H, Spinelli John J, Becker Nikolaus, Benhaim-Luzon Véronique, Bhatti Parveen, Boffetta Paolo, Brennan Paul, Brown Elizabeth E, Cocco Pierluigi, Costas Laura, Cozen Wendy, de Sanjosé Silvia, Foretová Lenka, Giles Graham G, Maynadié Marc, Moysich Kirsten, Nieters Alexandra, Staines Anthony, Tricot Guido, Weisenburger Dennis, Zhang Yawei, Baris Dalsu, Purdue Mark P
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, Maryland.
Cancer Epidemiol Biomarkers Prev. 2017 Jun;26(6):876-885. doi: 10.1158/1055-9965.EPI-16-0762-T. Epub 2017 Feb 21.
Multiple myeloma risk increases with higher adult body mass index (BMI). Emerging evidence also supports an association of young adult BMI with multiple myeloma. We undertook a pooled analysis of eight case-control studies to further evaluate anthropometric multiple myeloma risk factors, including young adult BMI. We conducted multivariable logistic regression analysis of usual adult anthropometric measures of 2,318 multiple myeloma cases and 9,609 controls, and of young adult BMI (age 25 or 30 years) for 1,164 cases and 3,629 controls. In the pooled sample, multiple myeloma risk was positively associated with usual adult BMI; risk increased 9% per 5-kg/m increase in BMI [OR, 1.09; 95% confidence interval (CI), 1.04-1.14; = 0.007]. We observed significant heterogeneity by study design ( = 0.04), noting the BMI-multiple myeloma association only for population-based studies ( = 0.0003). Young adult BMI was also positively associated with multiple myeloma (per 5-kg/m; OR, 1.2; 95% CI, 1.1-1.3; = 0.0002). Furthermore, we observed strong evidence of interaction between younger and usual adult BMI ( <0.0001); we noted statistically significant associations with multiple myeloma for persons overweight (25-<30 kg/m) or obese (30+ kg/m) in both younger and usual adulthood (vs. individuals consistently <25 kg/m), but not for those overweight or obese at only one time period. BMI-associated increases in multiple myeloma risk were highest for individuals who were overweight or obese throughout adulthood. These findings provide the strongest evidence to date that earlier and later adult BMI may increase multiple myeloma risk and suggest that healthy BMI maintenance throughout life may confer an added benefit of multiple myeloma prevention. .
成人身体质量指数(BMI)越高,患多发性骨髓瘤的风险越高。新出现的证据也支持青年成人BMI与多发性骨髓瘤之间存在关联。我们对八项病例对照研究进行了汇总分析,以进一步评估人体测量学方面的多发性骨髓瘤风险因素,包括青年成人BMI。我们对2318例多发性骨髓瘤病例和9609例对照的常规成人人体测量指标进行了多变量逻辑回归分析,并对1164例病例和3629例对照的青年成人BMI(25岁或30岁)进行了分析。在汇总样本中,多发性骨髓瘤风险与常规成人BMI呈正相关;BMI每增加5kg/m²,风险增加9%[比值比(OR),1.09;95%置信区间(CI),1.04 - 1.14;P = 0.007]。我们观察到研究设计存在显著异质性(P = 0.04),仅在基于人群的研究中发现BMI与多发性骨髓瘤存在关联(P = 0.0003)。青年成人BMI也与多发性骨髓瘤呈正相关(每增加5kg/m²;OR,1.2;95%CI,1.1 - 1.3;P = 0.0002)。此外,我们观察到青年和常规成人BMI之间存在强烈的相互作用证据(P < 0.0001);我们注意到,在青年期和成年期超重(25 - <30kg/m²)或肥胖(30+kg/m²)的人群与多发性骨髓瘤存在统计学显著关联(与始终<25kg/m²的个体相比),但仅在一个时期超重或肥胖的人群则不然。在整个成年期超重或肥胖的个体,BMI相关的多发性骨髓瘤风险增加最高。这些发现提供了迄今为止最有力的证据,表明成年早期和晚期的BMI可能增加多发性骨髓瘤风险,并表明终生维持健康的BMI可能在预防多发性骨髓瘤方面带来额外益处。