Our latest quiz highlights the role of bone marrow adiposity in patients with multiple myeloma.
C.High adult BMI
Obesity is the only known modifiable risk factor for multiple myeloma. According to a prospective analysis of data from three large cohort studies (the Nurse’s Health Study, the Health Professionals Follow-up Study, and the Women’s Health Study), high BMI in both early and late adulthood are risk factors for developing multiple myeloma.
D.All of the above
In recent years, researchers have identified roles of BMAT in multiple myeloma cell metabolism, inflammation, immune interaction, and effects on hypoxia and new blood cell vasculature. The endocrine activities of BMAT have been underappreciated until recently.
BMAT was long assumed to be inactive structural support, triggered by declines in bone mineral mass. More recently, researchers have demonstrated that fat-storing adipocytes are actively involved in cancer cell activity in bone marrow.
BMAT adipocytes secrete leptin, adiponectin, resistin, adipsin, and visfatin. These adipokines play a healthy role in normal fat and energy metabolism; in obesity, however, secretion can become less well-regulated.
Researchers at the University of Alabama at Birmingham have reported that aggressive myeloma cells shift osteoblast progenitors toward production of adipocytes. Bone marrow from patients with multiple myeloma contains more pre-adipocytes and larger adipocytes than bone marrow from healthy controls. The researchers found that both pre-adipocytes and mature adipocytes directly recruit multiple myeloma cells.