Blood Lipid Characteristics And Clinical Significance In Patients With Multiple Myeloma

Background:Multiple myeloma(MM)is a hematologic malignancy characterized by unlimited proliferation of malignant plasma cells in bone marrow accompanied by monoclonal immunoglobulin production.In recent years,with the in-depth research of biology,genetics and oncogenesis of myeloma,the development of new technologies such as targeted therapy and bone marrow stem cell transplantation and the development of new technology significantly improve the prognosis of patients and survival,but most of people still inevitably relapse,treatment and prognosis of MM is still a problem to be solved.Lipid level can reflect the status of lipid metabolism in vivo,and many diseases are related to lipid metabolism disorder.Currently,the increasing evidence have showed that the levels of blood lipid and the development of tumors was closely correlated with each other.As early as the 1980 s,foreign studies show that serum cholesterol level is negatively correlated with cancer death.Epidemiological studies have also found that plasma cholesterol level is negatively correlated with the occurrence and mortality of cancer.But there are no consistent results that fully account for changes in lipid levels in patients with multiple myeloma.This study aims to detect the level of serum triglyceride(TG),total cholesterol(TC)and low density lipoprotein(LDL)in multiple myeloma patients to reflect the blood lipid metabolism characteristics of patients with multiple myeloma,and analyze its clinical characteristics with multiple myeloma,and the forecast effect on the prognosis and treatment of multiple myeloma.Objective:Through retrospective analysis of multiple myeloma(MM)patients,the characteristics of lipid metabolism in multiple myeloma(MM)patients were detected,as well as the relationship between lipid level and clinical characteristics of multiple myeloma,and the change trend of lipid level before and after chemotherapy was used to predict the effect of chemotherapy.Methods:A total of 79 MM patients with multiple myeloma who were first diagnosed in the second affiliated hospital of Nanchang university and underwent at least 4 cycles of chemotherapy between January 2012 and August 2019 were retrospectively collected.Collect the basic information,imaging examination of blood test report and related data,including gender,age,CRP,ESR,fasting serum glucose,albumin and creatinine,calcium ion,dissolve osseous lesion,immunoglobulin types and stages,as well as the first-line chemotherapy regimens in our hospital use four cycle after such inspection to check information.Meanwhile,67 healthy subjects from the physical examination center of the second affiliated hospital of Nanchang university were retrospectively collected as the control group,and their age and gender were matched with those of multiple myeloma patients.SPSS25.0 statistical software was used for statistical analysis of data,and Kolmogorov-Smirnov was used for normal distribution analysis of inter-group data.The measurement data conforming to the normal distribution is expressed by `X±S,the independent sample t test was used for the comparison of the mean between the two groups,and the ANOVO one-way analysis of variance was used for the comparison between multiple groups.The measurement data that did not meet the normal distribution were expressed by the median(P25%-P75%).The samples were compared using the Mann-Whitney U test,the independent samples between multiple groups were compared using the non-parametric test Kruskal-Wallis H test,and the paired samples were using the non-parametric test Wilcoxon signed rank sum test.P <0.05 was considered statistically significant.Results:1、The TC and LDL of multiple myeloma patients were lower than that of normal healthy control group,and the difference was statistically significant(P(27)0.05).The TG level was higher than that of normal control group,and the difference was not statistically significant(P(29)0.05)2、Women with multiple myeloma had higher levels of TC,TG and LDL than men,but the difference was not statistically significant(P(29)0.05).The difference in blood lipid level was not related to the age difference of patients(P(29)0.05).Ig G type in multiple myeloma was higher than that in Ig A type TC and LDL,the difference was statistically significant(P(27)0.05).In ISS staging,LDL of stage III patients was lower than that of stage I patients,and the difference was statistically significant(P(27)0.05).In the d-s stage,the TC and LDL of stage III patients were higher than those of stage I patients,and the difference was statistically significant(P(27)0.05).Patients with multiple myeloma anemia had lower TC and LDL than those without anemia,and the difference was statistically significant(P(27)0.05).Patients with multiple myeloma with low albumin had lower TC and LDL than patients with normal albumin,and the difference was statistically significant(P(27)0.05).3、After 4 cycles of first-line chemotherapy,the TC,TG and LDL of patients with multiple myeloma increased compared with those before chemotherapy,with statistically significant differences(P(27)0.05).After 4 cycles of chemotherapy,the LDL of MM patients evaluated as CR increased after chemotherapy,and the difference was statistically significant.Patients with VGPR and PR had higher TC and LDL after chemotherapy than those before chemotherapy,and the difference was statistically significant(P(27)0.05).TG level was not significantly different(P(29)0.05).There were no statistically significant differences in TC,TG and LDL levels in SD MM patients after chemotherapy compared with those before chemotherapy(P(29)0.05).Conclusion:Low lipid levels are seen in patients with multiple myeloma.Ig G type had a higher level of blood lipid than other types;The higher the clinical stage of multiple myeloma patients,the lower the level of blood lipid;The serum lipid level of multiple myeloma patients after chemotherapy was higher than that before chemotherapy,and the worse the effect of chemotherapy was,The worse the effect of chemotherapy,the lower the rise of LDL level;The serum lipid level can be used to evaluate the type,clinical stage,prognosis and effect of chemotherapy in patients with multiple myeloma.