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Subcutaneous Adipose Tissue Radiodensity: Prognostic Indicator in Myeloma?

By: Kelly M. Hennessey, PhD
Posted: Monday, May 3, 2021

Obesity is thought to be a risk factor for multiple myeloma, yet a relationship between adipose tissue radiodensity and prognosis in this hematologic malignancy has not been investigated. José Barreto Campello Carvalheira, MD, PhD, of the State University of Campinas, Brazil, and colleagues recently analyzed body composition radiodensity in patients with myeloma and found that both event-free survival and overall survival were shorter in those with high subcutaneous adipose tissue radiodensity. Their results were published in Nutrition.

In total, 91 patients treated for multiple myeloma met inclusion criteria. Of those included, 10 patients underwent CT scanning, and 81 underwent fludeoxyglucose F 18 (18F-FDG) PET with CT examination.

Researchers evaluated selected demographic and disease characteristics according to the distribution of subcutaneous adipose tissue radiodensity. They also investigated body composition, subcutaneous and visceral adipose tissue and inflammatory indexes, and adipocytokine levels according to three subcutaneous adipose tissue radiodensity levels.

Patients with higher subcutaneous adipose tissue radiodensity showed lower visceral adipose tissue area, visceral adipose tissue index, subcutaneous adipose tissue area, and subcutaneous adipose tissue index, and higher levels of proinflammatory cytokines. Furthermore, those with higher subcutaneous adipose tissue radiodensity had lower subcutaneous adipose tissue area and higher visceral adipose tissue and intramuscular adipose tissue radiodensity.

Patients with the highest subcutaneous adipose tissue radiodensity had an independently higher risk for both event-free survival (hazard ratio [HR] = 3.08; 95% confidence interval [CI] = 1.02–9.27; P trend = .035) and overall survival (HR = 4.55; 95% CI = 1.26–16.44; P trend = .036). Both sex-specific subcutaneous adipose tissue and visceral adipose tissue radiodensity were not independently associated with event-free survival, but they were linked to shorter overall survival.

Their findings suggest that subcutaneous adipose tissue radiodensity may be used as a biomarker to reveal energy depletion and a proinflammatory environment caused by multiple myeloma, leading to poor clinical outcomes.

Disclosure: The study authors reported no conflicts of interest.

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