肥胖是一种全球性的大流行病，并与乳腺、子宫内膜、大肠、肾脏、食管和胰腺癌的发展有关。肥胖也参与心血管疾病和2型糖尿病的发展。最近，肥胖相关癌症的发病率增加报告增加。多发性骨髓瘤（MM）是仅次于淋巴瘤的第二常见的血液系统恶性肿瘤。本综述的目的是检查肥胖和MM的流行病学数据，评估肥胖对MM结果的影响，评估肥胖可能通过哪些机制增加MM的发病率，并提供肥胖管理对MM的影响。目前的证据表明，肥胖可能对未定性单克隆球蛋白病（MGUS）到MM的进展和MM的患病率造成影响。然而，关于肥胖对MGUS发病率的影响的数据是有争议的，需要进一步研究来确定肥胖是否影响MGUS的发展或MGUS到MM的进展。此外，肥胖会影响MM的结果。BMI增加与MM患者生存率下降有关，而关于肥胖对新诊断的MM患者和自体干细胞移植的影响的数据有限。有趣的是，肥胖患者在复发/难治性MM方面可能也适用于肥胖矛盾，因为他们可能具有生存优势。将肥胖与MM联系起来的病理生理途径非常复杂，包括骨髓脂肪组织；脂肪素，如脂联素，瘦素，抗瘦素和Visfatin；炎症性细胞因子和生长因子，如TNF-α和IL-6；激素，包括胰岛素和胰岛素样生长因子系统以及性激素。在药物治疗肥胖的影响方面，奥利司他已被证明可以改变MM细胞的增殖，而关于胰高血糖素样肽-1受体激动剂，纳尔曲酮/丁丙腈或苯甲酸盐/托吡酯的数据不存在。减肥手术可能与MM的发病率降低有关，但是需要进一步研究。Copyright © 2023. Elsevier有限公司发表。

Obesity is a global pandemic that has been associated with the development of breast, endometrial, large intestine, renal, esophageal, and pancreatic cancer. Obesity is also involved in the development of cardiovascular disease and type 2 diabetes mellitus. Recently, an increase in the incidence of obesity-related cancers has been reported. Multiple myeloma (MM) is the second most common hematological malignancy, after lymphoma. The aim of this review is to examine the epidemiological data on obesity and MM, assess the effect of obesity on MM outcomes, evaluate the possible mechanisms through which obesity might increase the incidence of MM and provide the effects of obesity management on MM. Current evidence indicates that obesity may have an impact on the progression of monoclonal gammopathy of undetermined significance (MGUS) to MM and increase the prevalence of MM. However, data regarding the effect of obesity on MGUS incidence are controversial; further studies are needed to examine whether obesity affects the development of MGUS or the progression of MGUS to MM. In addition, obesity affects MM outcomes. Increased BMI is associated with decreased survival in patients with MM, while data regarding the effect of obesity on newly diagnosed MM subjects and autologous stem cell transplantation are limited. Interestingly, the obesity paradox may also apply to patients with relapsed/refractory MM who are overweight or obese, because they may have a survival advantage. The pathophysiological pathways linking obesity to MM are very complicated and include bone marrow adipose tissue; adipokines, such as adiponectin, leptin, resistin, and visfatin; inflammatory cytokines and growth factors, such as TNF-α and IL-6; hormones including insulin and the insulin-like growth factor system as well as sex hormones. In terms of the effect of pharmacological management of obesity, orlistat has been shown to alter the proliferation of MM cells, whereas no data exist on glucagon-like peptide-1 receptor agonists, naltrexone/bupropion, or phentermine/topiramate. Bariatric surgery may be associated with a reduction in the incidence of MM, however, further studies are needed.Copyright © 2023. Published by Elsevier Ltd.