Li Yimeng, Hsu Sylvia H, Wang Rong, Theprungsirikul Poy, Neparidze Natalia, Chang Su-Hsin, Wang Shi-Yi
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT.
Schulich School of Business, York University, Toronto, Canada.
Clin Lymphoma Myeloma Leuk. 2025 Apr;25(4):e222-e231. doi: 10.1016/j.clml.2024.12.006. Epub 2024 Dec 6.
Monoclonal gammopathy of undetermined significance (MGUS) is a pre-malignant condition of multiple myeloma (MM). Evidence suggested old age, black race, male gender, and obesity as risk factors for MGUS development; however, whether they are associated with an increased risk of progression to MM among patients with MGUS is unclear. A systematic search of PUBMED and EMBASE for cohort studies investigating the association between age/race/gender/obesity and progression to MM. We used the Newcastle-Ottawa Scale (NOS) to assess the methodologic quality of the included studies. Summary risk ratios were calculated using random-effects models. We identified 24 publications, of which 17 articles were included in the main analyses. Overall, the quality of the studies was fair (mean NOS = 5.5). Our meta-analyses showed that old age was positively associated with the risk of the MGUS-MM progression (risk ratio: 2.38; 95% confidence interval [CI] 1.59-3.57), while race was not statistically significantly associated with the risk (blacks vs whites: 1.09; 95% CI: 0.77-1.54). Males had a lower risk of MGUS-MM progression, compared to females (risk ratio: 0.70; 95% CI 0.50-1.0; P-value = .048). High body mass index was significantly associated with an increased risk of MGUS-MM progression (risk ratio: 1.32; 95% CI 1.12-1.57). Based on extant research, old age, female sex, and obesity may be implicated in MGUS-MM progression. However, several studies which found an insignificant association between age/gender and progression did not report the risk estimates. Publication bias exists and our risk estimates may be overestimated. More studies are warranted to confirm our findings.
意义未明的单克隆丙种球蛋白病（MGUS）是多发性骨髓瘤（MM）的一种癌前状态。有证据表明，老年、黑人种族、男性以及肥胖是MGUS发生的危险因素；然而，它们是否与MGUS患者进展为MM的风险增加相关尚不清楚。我们对PUBMED和EMBASE进行了系统检索，以查找调查年龄/种族/性别/肥胖与进展为MM之间关联的队列研究。我们使用纽卡斯尔-渥太华量表（NOS）来评估纳入研究的方法学质量。使用随机效应模型计算汇总风险比。我们识别出24篇出版物，其中17篇文章纳入主要分析。总体而言，研究质量为中等（平均NOS = 5.5）。我们的荟萃分析表明，老年与MGUS进展为MM的风险呈正相关（风险比：2.38；95%置信区间[CI] 1.59 - 3.57），而种族与该风险无统计学显著关联（黑人与白人相比：1.09；95% CI：0.77 - 1.54）。与女性相比，男性MGUS进展为MM的风险较低（风险比：0.70；95% CI 0.50 - 1.0；P值 = 0.048）。高体重指数与MGUS进展为MM的风险增加显著相关（风险比：1.32；95% CI 1.12 - 1.57）。基于现有研究，老年、女性性别以及肥胖可能与MGUS进展为MM有关。然而，一些发现年龄/性别与进展之间无显著关联的研究未报告风险估计值。存在发表偏倚，我们的风险估计值可能被高估。需要更多研究来证实我们的发现。
