Inflammation and endogenous growth factors are important in multiple myeloma (MM) pathogenesis. Although diets that modulate these biologic pathways may influence MM patient survival, studies have not examined the association of dietary patterns with MM survival. We conducted pooled prospective survival analyses of 423 MM patients from the Nurses' Health Study (1986–2016) and the Health Professionals Follow‐up Study (1988–2016) using Cox regression models. We used data from repeated food frequency questionnaires (FFQ) to compute dietary patterns as of the last prediagnosis FFQ, including the Alternate Healthy Eating Index (AHEI)‐2010, alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent, Western and empirical dietary inflammatory patterns and empirical dietary indices for insulin resistance and hyperinsulinemia. During follow‐up, we documented 295 MM‐related deaths among 345 total deaths. MM‐specific mortality was 15–24% lower per one standard deviation (SD) increase (e.g., toward healthier habits) in favorable dietary pattern scores. For example, the multivariable‐adjusted hazard ratio [HR] and 95% confidence interval [CI] per 1‐SD increase in AHEI‐2010 score were 0.76, 0.67–0.87 (p  < 0.001). In contrast, MM‐specific mortality was 16–24% higher per 1‐SD increase (e.g., toward less healthy habits) in “unhealthy” diet scores; for example, the multivariable‐adjusted HR, 95% CI per 1‐SD increase in Western pattern score were 1.24, 1.07–1.44 (p = 0.005). Associations were similar for all‐cause mortality. In conclusion, our consistent findings for multiple dietary patterns provide the first evidence that MM patients with healthier prediagnosis dietary habits may have longer survival than those with less healthy diets.

中文翻译：

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多发性骨髓瘤患者的预诊断饮食模式和生存率。

炎症和内源性生长因子在多发性骨髓瘤 (MM) 发病机制中很重要。尽管调节这些生物途径的饮食可能会影响 MM 患者的生存，但研究尚未检查饮食模式与 MM 生存的关联。我们使用 Cox 回归模型对来自护士健康研究 (1986-2016) 和卫生专业人员随访研究 (1988-2016) 的 423 名 MM 患者进行了汇总前瞻性生存分析。我们使用重复食物频率问卷 (FFQ) 的数据来计算截至上次诊断前 FFQ 的饮食模式，包括替代健康饮食指数 (AHEI)‐2010、替代地中海饮食、停止高血压的饮食方法、谨慎、西方和经验饮食胰岛素抵抗和高胰岛素血症的炎症模式和经验性饮食指数。在随访期间，我们记录了 345 例死亡总数中的 295 例与 MM 相关的死亡。在有利的饮食模式评分中，每增加一个标准差 (SD)（例如，朝着更健康的习惯），MM 特异性死亡率就会降低 15-24%。例如，AHEI-2010 评分每增加 1-SD 的多变量调整风险比 [HR] 和 95% 置信区间 [CI] 分别为 0.76、0.67–0.87（p  < 0.001)。相比之下，在“不健康”饮食评分中，MM 特异性死亡率每增加 1 个标准差（例如，朝向不太健康的习惯），就会增加 16-24%；例如，Western 模式评分每增加 1 个 SD 的多变量调整 HR 95% CI 分别为 1.24、1.07–1.44 ( p = 0.005)。全因死亡率的相关性相似。总之，我们对多种饮食模式的一致发现提供了第一个证据，即具有更健康的诊断前饮食习惯的 MM 患者可能比那些饮食不健康的患者具有更长的生存期。