累积多余体重指数和MGUS进展到髓瘤
Lawrence Liu1,2, Nikhil Grandhi1,3, Mei Wang1,4
1Research Service, St Louis Veterans Affairs Medical Center, St Louis, Missouri.
JAMA network open
|February 7, 2025
概括
累积多余体重指数 (EBMI) 增加了未知意义的单克隆性胃病变 (MGUS) 进展为多发性骨髓瘤 (MM) 的风险. 在MGUS诊断后保持健康的体重可能有助于预防这种进展.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 肥胖是多发性骨髓瘤 (MM) 和其前体,意义不明的单克隆性骨髓瘤病 (MGUS) 的已知危险因素.
- 累积肥胖暴露对从MGUS发展为MM的风险的影响尚不清楚.
研究的目的:
- 调查累积多余体重指数 (EBMI) 与从MGUS发展为MM的风险之间的关联.
- 确定持续的肥胖是否会影响MGUS发展为MM的速度.
主要方法:
- 一项队列研究分析了1999年至2021年间诊断出MGUS的22429名美国退伍军人的数据.
- 累计EBMI的计算是使用BMI在诊断后的前三年超过25的曲线下的面积.
- 采用多变量细灰竞争风险模型来评估EBMI和MGUS进展到MM之间的关联.
主要成果:
- 在MGUS诊断时体重指数 (BMI) 为25或以上的患者与正常BMI患者相比,患MM的风险更高.
- 在诊断时BMI正常的患者中,每年累积EBMI每增加1个单位都与进展风险增加21%有关.
- 对于在诊断时已经超重或肥胖的患者 (BMI ≥25),累积EBMI没有显示出与进展风险增加的统计学上显著关联.
结论:
- 累积的多余体重指数与MGUS进展到多发性骨髓瘤的风险增加有关,特别是在诊断时BMI正常的个体中.
- 在MGUS诊断后保持健康的体重和稳定的BMI可能是预防风险人群发展为MM的关键策略.
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