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MGUS Risk Increases w/ Excess BMI
MGUS patients with an increased BMI have an increased risk of progressing to multiple myeloma. To put this another way, MGUS patients no longer need to “watch and wait.”
The usual statistic given to newly diagnosed MGUS patients is that their risk of progressing to frank MM is 1% per year. But according to the article, video and list of modifiable risk factors below, there are many factors that can change this risk of progression.
What modifiable factors increase the risk of MGUS patients progressing to full multiple myeloma?
Monoclonal gammopathy of undetermined significance (MGUS) can progress to multiple myeloma (MM) or other plasma cell disorders at a rate of about 1% per year. Several controllable factors may increase this risk, including:
1. Obesity and Metabolic Factors
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Studies suggest that obesity and a higher body mass index (BMI) are associated with an increased risk of MGUS progressing to multiple myeloma.
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Insulin resistance and metabolic syndrome may contribute to disease progression.
2. Chronic Inflammation & Infections
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Persistent chronic inflammation (from infections, autoimmune diseases, or other chronic conditions) can create an environment that supports malignant transformation.
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Reducing inflammation through diet, lifestyle changes, and proper management of chronic diseases may lower risk.
3. Smoking and Alcohol Consumption
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Smoking has been linked to a higher risk of progression in some studies.
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Excessive alcohol consumption can also contribute to immune system dysregulation, which might influence disease progression.
4. Diet and Nutrition
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High-fat, high-sugar diets may promote a pro-inflammatory state, increasing the risk of progression.
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Anti-inflammatory diets (rich in fruits, vegetables, omega-3 fatty acids, and fiber) might reduce risk.
5. Physical Inactivity
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A sedentary lifestyle can contribute to obesity, inflammation, and immune system dysfunction, all of which are associated with MGUS progression.
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Regular physical activity may help modulate immune function and reduce risk.
6. Exposure to Environmental Toxins
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Pesticides, herbicides, benzene, and heavy metals have been implicated in plasma cell disorders.
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Reducing exposure to such toxins (e.g., using protective gear, avoiding contaminated environments) may lower the risk.
7. Vitamin D Deficiency
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Low vitamin D levels have been associated with an increased risk of progression.
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Ensuring adequate vitamin D through sunlight exposure, diet, or supplementation may be beneficial.
8. Poor Immune System Function
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Chronic stress, lack of sleep, and poor gut health can contribute to immune dysregulation.
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Improving immune function through stress management, good sleep hygiene, and a balanced diet may help.
High-Fiber NUTRIVENTION Study for Delaying Progression of Myeloma
A growing number of studies document the fact that MGUS risk of progression to MM can be affected by lifestyle, nutrition and supplementation.
I am a long-term MM survivor. I was originally diagnosed with a single plasmacytoma of bone (SPB) a form of pre-MM. That was the time when oncology paid little attention to “blood disorders” like mine. Times are changing for the SBP, MGUS and SMM patient.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about evidence-based non-conventional therapies shown to reduce the risk of multiple myeloma.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Cumulative Excess Body Mass Index and MGUS Progression to Myeloma
Question To what extent is cumulative exposure to excess body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) associated with risk of progression from monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM)?
Findings In this cohort study of 22 429 patients with MGUS, among those with BMI of 18.5 to less than 25 at MGUS diagnosis, each 1-unit increase of excess BMI (ie, >25) per year was associated with a statistically significant 21% higher risk of progression to MM.
Meaning These findings suggest that maintaining a healthy and stable weight may prevent progression of MGUS to MM.
Importance Obesity is a risk factor associated with multiple myeloma (MM) and its precursor, monoclonal gammopathy of unknown significance (MGUS). However, it is unclear how cumulative exposure to obesity affects the risk of MGUS progression to MM.
Objective To determine the association of cumulative exposure to excess body mass index (EBMI), defined as BMI (calculated as weight in kilograms divided by height in meters squared) greater than 25, with risk of MGUS progression to MM…
Exposures Cumulative EBMI was calculated by area under the curve of measured BMI subtracting the reference BMI at 25 during the first 3 years after MGUS diagnosis.
Main Outcomes and Measures The main outcome was progression from MGUS to MM. Multivariable Fine-Gray time-to-competing-event analyses, with death as the competing event, were used to determine associations.
Results The cohort included 22 429 patients with MGUS (median [IQR] age, 70.5 [63.5-77.9] years; 21 613 [96.4%] male), with 8329 Black patients (37.1%) and 14 100 White patients (62.9%). There were 4862 patients (21.7%) with reference range BMI (18.5 to <25),
7619 patients (34.0%) with BMI 25 to less than 30, and 8513 patients (38.0%) with BMI 30 or greater at the time of MGUS diagnosis. Compared with reference range BMI at MGUS diagnosis, patients with BMI 25 to less than 30 (adjusted hazard ratio [aHR], 1.17; 95% CI, 1.03-1.34) or 30 or greater (aHR, 1.27; 95% CI, 1.09-1.47) at MGUS diagnosis had higher risk of progression to MM.
In patients with reference range BMI at MGUS diagnosis, each 1-unit increase of EBMI per year was associated with a 21% increase in progression risk (aHR, 1.21; 95% CI, 1.04-1.40). However, for patients with BMI 25 or greater at MGUS diagnosis, the incremental risk associated with cumulative EBMI exposure was not statistically significant.
Conclusions and Relevance This cohort study found that, for patients with BMI 18.5 to less than 25 at the time of MGUS diagnosis, cumulative exposure to BMI 25 or greater was associated with an increased risk of progression.
These findings suggest that for these patients, maintaining a healthy and stable weight following MGUS diagnosis may prevent progression to MM.
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