New research published by Blood Advances indicates the modifiable risk factor of obesity is associated with the benign precursor of myeloma known as monoclonal gammopathy of undetermined significance (MGUS). 

Understanding MGUS in Relation to Myeloma

Receiving a diagnosis of MGUS can be confusing, foreign, and scary, especially when you hear the dreaded word cancer. What exactly is MGUS, and how can it increase your risk of developing myeloma?

Myeloma is a type of blood cancer that affects explicitly blood cells known as plasma. Plasma is an integral part of the body’s immune system. The plasma cells arise from bone marrow cells called B lymphocytes. B lymphocytes transform into plasma cells when the body’s immune system recognizes a foreign invader (i.e., viruses like the flu or bacteria like Staph). 

The plasma cells respond by releasing proteins known as antibodies that surround the virus or bacteria to enable other immune system cells to find and destroy these trespassers. In the case of myeloma, the plasma cells proliferate uncontrollably and release unneeded antibodies. Thus, the accumulation of plasma cells and antibodies results in the classic symptoms of myeloma: anemia, weakened bones, and acute renal failure. 

MGUS is a premalignant condition, or inactive form, of multiple myeloma. The cancerous plasma cells are present and produce monoclonal proteins (M-proteins [an antibody]), but something environmentally or genetically does not favor the progression to myeloma. 

For individuals affected with MGUS, there is a 1% chance per year of MGUS progressing to myeloma; most affected with MGUS lack signs and symptoms to indicate the condition. African Americans are three times more likely to develop MGUS, and people with first-degree relatives with MGUS have a two to three times higher chance of developing MGUS. There are few known risk factors for the development of MGUS. However, recent primary research conducted by Lee et al. indicates a positive correlation between the development of MGUS with obesity.

Understanding BMI and Obesity

Obesity is a common condition for many Americans, but not everyone understands the health implications obesity can have. Let’s discuss how obesity is classified and how it can affect your health.

According to the Centers for Disease Control and Prevention, a body mass index (BMI) of over 30 categorizes a person as obese, and “more than 2 in 5 adults (42.4%) have obesity” in the United States. There are many known conditions and diseases associated with obesity, such as diabetes, hypertension, heart failure, gallbladder disease, sleep apnea, and now MGUS. 

Understanding the Connections Between MGUS and Obesity

Now that we understand what obesity is, let’s look into how obesity can increase high-risk individuals' risk of developing MGUS.

In their research, Lee et al. sampled blood from 2,628 people with an elevated myeloma risk across the United States. Participants qualified for the study if they were of African descent or had a family history of hematological cancer or premalignant conditions such as MGUS.

The participants' blood samples were run through mass spectrometry, a laboratory test that identifies separate charges and masses of the components present in the sample. Individual samples with a concentration of M-proteins of more than or equal to 0.2 g/L were categorized as mass spectrometry MGUS (MS-MGUS).

Individuals with a BMI greater than or equal to 30 were associated with MS-MGUS after stripping away the effects of other factors such as age, sex, Black race, education, and income. In fact, “being obese was associated with a 73% higher odds of MS-MGUS, relative to normal weight individuals.”

With a significant statistical finding of MS-MGUS being associated with obesity as a risk factor, this could be groundbreaking in preventing MGUS development in high-risk individuals. Suppose an individual is known to be of African descent or has a family history of blood cancer.

In that case, the development of MGUS may be prevented by maintaining a healthy BMI of 18.5 to 24.9. However, further research must be conducted to validate these preliminary findings and to determine if other modifiable risk factors (smoking and lack of sleep) could contribute to the development of MGUS in high-risk individuals.

Conclusion

All of this information can seem overwhelming, but the truth is that diagnoses like that of MGUS or myeloma are overwhelming! However, educating yourself to participate in your medical care is important because, with an adequate understanding, you may be able to participate actively in your medical care. 

My grandfather passed away in 2021 due to metastasized lung cancer; he had been showing signs and symptoms of cancer in the year before his diagnosis, but the family, myself, and his primary care provider were unable to put the pieces of the puzzle together in time.

Therefore, I want to help educate those potentially at risk or currently experiencing premalignant or malignant conditions about the risk factors, signs and symptoms, and various treatments available to give them the best chance possible. 

If you are at high risk for MGUS development and have a BMI nearing 30 but don’t know how to lose weight, schedule an appointment with your primary care provider or a registered dietitian, or simply start walking for thirty minutes at least five days a week.

MGUS has the potential to affect many people at high risk who are obese, so don’t feel ashamed to seek professional help in deterring MGUS development; you’re not alone.

Research Articles and Resources 

1. Centers for Disease Control and Prevention. (2022, June 03). About adult BMI. 
2. HealthTree Foundation for Multiple Myeloma (2012, October 09). Types of multiple myeloma.
3. HealthTree University Myeloma. (2020, May 27). What is MGUS? Is it cancer? How many people have MGUS, and how long can I have it? [Video]. Youtube. 
4. Lee, D.J., El-Khoury, H., Tramontano, A.C., Alberge, J.B., Perry, J., Davis, M.I., Horowitz, E., Redd, R.A., Sakrikar, D., Barndige, D., Perkins, M.C., Harding, S., Mucci, L., Rebbeck, T.R., Ghobrial, I.M., & Marinac, C.R. (2024, January 11). Mass spectrometry-detected MGUSD is associated with obesity and other novel modifiable risk factors in a high-risk population. Blood Advances, 1-30. 
5. National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Overweight & obesity statistics.