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新诊断多发性骨髓瘤患者的体重指数与总生存期

Body Mass Index and Overall Survival of Patients with Newly Diagnosed Multiple Myeloma.

作者信息

Wang Bei, Derman Benjamin A, Langerman Spencer S, Johnson Julie, Zhang Wei, Jakubowiak Andrzej, Chiu Brian C-H

机构信息

Department of Public Health Sciences, University of Chicago, Chicago, IL 60637, USA.

Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.

出版信息

Cancers (Basel). 2022 Oct 29;14(21):5331. doi: 10.3390/cancers14215331.

Abstract

Obesity is associated with survival in several solid tumors and non-Hodgkin lymphoma, but its impact on multiple myeloma (MM) survival is unclear. We examined the associations between body mass index (BMI) at different periods of life up to the time of diagnosis and overall survival (OS) among 563 patients newly diagnosed with MM in 2010-2019. BMI at diagnosis was calculated using measured height and weight from electronic medical records (EMR). BMIs at age 20, maximum during adulthood, and 5 years before diagnosis were calculated using self-reported weights and measured height from EMR. Over a median follow-up of 49.3 months, 191 (33.93%) deaths were identified. We used multivariable Cox proportional-hazards models to examine the associations between BMIs and OS. Height as well as BMI before and at diagnosis was not associated with OS, but there is a U-shape association between weight and OS. Higher BMIs at diagnosis were associated with better OS among females (HR = 0.39 [0.22-0.71]), irrespective of race. In conclusion, our results suggest that BMI at different periods of life up to the time of diagnosis may not be associated with OS in MM, except that a higher BMI at diagnosis was associated with superior OS for females.

摘要

肥胖与多种实体瘤和非霍奇金淋巴瘤的生存率相关,但它对多发性骨髓瘤(MM)生存率的影响尚不清楚。我们研究了2010年至2019年新诊断为MM的563例患者在诊断前不同生命阶段的体重指数(BMI)与总生存期(OS)之间的关联。诊断时的BMI使用电子病历(EMR)中测量的身高和体重计算得出。20岁时、成年期最高体重时以及诊断前5年的BMI使用自我报告的体重和EMR中测量的身高计算得出。在中位随访49.3个月期间,确定了191例(33.93%)死亡病例。我们使用多变量Cox比例风险模型来研究BMI与OS之间的关联。身高以及诊断前和诊断时的BMI与OS无关,但体重与OS呈U形关联。诊断时较高的BMI与女性更好的OS相关(HR = 0.39 [0.22 - 0.71]),与种族无关。总之,我们的结果表明,在诊断前不同生命阶段的BMI可能与MM的OS无关,除非诊断时较高的BMI与女性更好的OS相关。

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