Department of Pathology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Division of Hematology and Medical Oncology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Br J Cancer. 2024 Jul;131(2):312-324. doi: 10.1038/s41416-024-02723-6. Epub 2024 Jun 7.
Obesity is an established modifiable risk factor for multiple myeloma (MM). However, associations of obesity and MM risk in Black populations, for whom obesity and MM are more common, is less clear.
Using participants enrolled in the Integrative Molecular And Genetic Epidemiology study, we evaluated the association of anthropometric traits with MM risk overall, stratified by race and sex. Among cases, we assessed the association of BMI with the presence of myeloma-defining events.
We observed an 18% increase in MM risk for every 5 kg/m increase in usual adult BMI. Participants with severe obesity (BMI ≥ 40 kg/m) had the highest risk compared to those with a normal usual adult BMI (18.5-24.9 kg/m; OR = 1.87, 95% CI 1.25-2.80), particularly among Black men (OR = 3.94, 95% CI 0.90-17.36). Furthermore, MM cases with overweight/obesity (BMI ≥ 25 kg/m) were more likely to present at diagnosis with low renal function (OR = 1.62, 95% CI 1.09-2.40), deletion 13q (OR = 1.73, 95% CI 1.08-2.76) and lytic lesions or compression fractures (OR = 2.39, 95% CI 0.82-7.01) and less likely to present with severe diffuse osteopenia (OR = 0.51, 95% CI 0.31-0.81).
Findings underscore the importance of obesity as a modifiable risk factor for MM, particularly in high-risk populations, and for the clinical presentation of disease.
肥胖是多发性骨髓瘤(MM)的一个已确定的可改变的危险因素。然而,在肥胖和 MM 更为常见的黑人群体中,肥胖与 MM 风险之间的关联尚不清楚。
我们利用参加综合分子和遗传流行病学研究的参与者,根据种族和性别对人体测量特征与 MM 风险之间的关系进行了评估。在病例中,我们评估了 BMI 与骨髓瘤定义事件存在的关系。
我们发现,成年人通常 BMI 每增加 5kg/m,MM 风险就会增加 18%。与具有正常成年人通常 BMI(18.5-24.9kg/m)的参与者相比,肥胖程度严重(BMI≥40kg/m)的参与者风险最高(OR=1.87,95%CI 1.25-2.80),尤其是黑人男性(OR=3.94,95%CI 0.90-17.36)。此外,超重/肥胖(BMI≥25kg/m)的 MM 患者在诊断时更有可能出现肾功能不全(OR=1.62,95%CI 1.09-2.40)、缺失 13q(OR=1.73,95%CI 1.08-2.76)和溶骨性病变或压缩性骨折(OR=2.39,95%CI 0.82-7.01)的几率较低,而严重弥漫性骨质疏松症(OR=0.51,95%CI 0.31-0.81)的几率较高。
这些发现强调了肥胖作为 MM 的一个可改变的危险因素的重要性,尤其是在高危人群中,以及对疾病临床表现的重要性。