Study On The Value Of Serum Lipids In The Evaluation Of Patients With Multiple Myeloma

Objective To investigate the relationship between serum lipid index,severity,immune typing and efficacy in patients with primary multiple myeloma(MM).Methods A retrospective cohort of 138 newly diagnosed patients with multiple myeloma from January 2019 to December 2021 at Anhui Medical University First Affiliated Hospital and Anhui Medical University Chaohu Hospital was set up as MM group,while 80 healthy patients from the Medical Center were collected as normal controls to compare differences in blood lipid levels between the two groups.To analyze the correlation between serum lipid levels in MM patients with different clinical stages(ISS stage and DS stage)and different immune subtypes.Four courses of bortezomi-based chemotherapy were completed in 90 of 138 initially diagnosed MM patients.The 90 patients were divided into remission and non-remission groups according to their post-chemotherapy efficacy.The difference in serum lipid levels between the two groups was compared,and the predictive value of serum lipid for MM patients at initial diagnosis was further analyzed using the Receiver Operating Characteristic(ROC)Curve.Results TC,HDL-C,LDL-C,APOA and APOB in multiple myeloma group were significantly lower than those in control group,and the difference was statistically significant(P < 0.001).In ISS stage,the levels of TC,LDL-C and APOB in stage II patients were lower than those in stage I;the levels of TC,HDL-C,LDL-C,APOA and APOB in stage III patients were lower than those in stage I patients;the levels of TC,HDL-C,LDL-C and APOA in stage III patients were lower than those in stage II patients.The difference was statistically significant(P < 0.05).In DS stage,there was no significant difference in blood lipid between stage II patients and stage I(P > 0.05),the levels of TC,HDL-C,LDL-C,APOA and APOB in stage III patients were lower than those in stage I,and the levels of TC,HDL-C and APOA in stage III patients were lower than those in stage II,with statistical significance(P < 0.05).Among the 90 MM patients who completed four times of bortezomib based chemotherapy regimen,71 achieved remission and 19 did not remission.The levels of HDL-C and APOA in the non-remission group were lower than those in the remission group at initial diagnosis,and the difference was statistically significant(P < 0.05).ROC analysis showed that the levels of TC,HDL-C and APOA at initial diagnosis were predictive factors of chemotherapy efficacy in MM patients,and the area under the curve(AUC)were 0.659(95%CI: 0.538-0.779,P=0.034)and 0.718(95%CI: 0.606-0.830,P=0.004),0.676(95%CI: 0.549-0.803,P=0.019),HDL-C had the best prediction effect,and the optimal critical value was 1.00mmol/L,with a sensitivity of 94.7% and a specificity of 53.5%.Conclusion 1.Serum levels of TC,HDL-C,LDL-C,APOA and APOB in patients with multiple myeloma were significantly lower than those of healthy people of the same age.2.The levels of serum TC,HDL-C,LDL-C,APOA and APOB in newly diagnosed multiple myeloma patients were negatively correlated with the clinical staging of the disease(ISS stage and DS stage),suggesting that blood cholesterol level can be used as a reference index for the clinical staging of multiple myeloma.3.HDL-C level at initial diagnosis is a predictor of outcome in multiple myeloma patients receiving bortezomib based chemotherapy regiments.