The burden trend and risk factors of multiple myeloma from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021

IMPORTANCEMM was an incurable clonal plasma cell malignancy with substantial prevalence and incidence, which had resulted in a significant burden of disease. Our study aimed to evaluate the global, regional and national burden of MM by sex, age, and SDI from 1990 to 2021, along with associated risk factors and predicted temporal trends. OBJECTIVETo assess the global burden, epidemiological trends, and risk factors of MM and project its incidence rate by 2050. DesignThis is a systematic analysis of the global burden of MM from 1990 to 2021. SettingThe study primarily analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of MM from Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2021, by region, age, sex, and SDI. ParticipantsThe study builds on findings from the GBD 2021. ExposureMultiple myeloma. Main Outcomes and MeasuresThe Joinpoint regression was used to describe the trends. Two-sample Mendelian randomization (MR) analysis was conducted to identify the causal relationship between weight-related risk factors and MM. The Bayesian age-period-cohort (BAPC) model was used to predict the future trend. ResultsIn 2021, the age-standardized prevalence rate (ASPR) of MM was 4.65 (95% UI: 4.21 to 5.01) per 100,000 people, and the age-standardized mortality rate (ASMR) was 1.40 (95% UI: 1.24 to 1.52) per 100,000 people globally. The burden of MM was the highest in the high SDI region, with Monaco and Bahamas reporting the highest age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and ASMR in 2021. Simultaneously, ASRs peaked in the elderly population and were higher in males than in females. GBD 2021 reported high body mass index (BMI) as a risk factor for MM which was further confirmed by two-sample MR analysis. Additionally, BMI, waist circumference, obesity class 1, obesity class 2, overweight and hip circumference were also risk factors for MM. By 2050, the global incidence rate was predicted to decrease slightly but increase within the age group of 20-69. Conclusions and RelevanceThis study found that MM remained a significant public health issue, particularly in high SDI regions and among the elderly. A causal relationship exists between MM and body weight, indicating the need for targeted prevention and intervention strategies in high-risk regions and populations.