Bone disease in monoclonal gammopathy of undetermined significance: results from a screened population-based study

被引:26
作者
Thorsteinsdottir, Sigrun [1 ,2 ]
Lund, Sigrun H. [2 ]
Lindqvist, Ebba K. [3 ,4 ]
Thordardottir, Marianna [2 ]
Sigurdsson, Gunnar [5 ]
Costello, Rene [6 ]
Burton, Debra [6 ]
Steingrimsdottir, Hlif [1 ]
Gudnason, Vilmundur [2 ,5 ]
Eiriksdottir, Gudny [5 ]
Siggeirsdottir, Kristin [5 ]
Harris, Tamara B. [7 ]
Landgren, Ola [8 ]
Kristinsson, Sigurdur Y. [1 ,2 ]
机构
[1] Landspitali, Dept Internal Med, Reykjavik, Iceland
[2] Univ Iceland, Fac Med, Sturlugata 8, IS-101 Reykjavik, Iceland
[3] Karolinska Univ Hosp, Div Hematol, Dept Med, Stockholm, Sweden
[4] Karolinska Inst, Stockholm, Sweden
[5] Iceland Heart Assoc, Kopavogur, Iceland
[6] NCI, Ctr Canc Res, Bethesda, MD 20892 USA
[7] NIA, NIH, Bethesda, MD 20892 USA
[8] Mem Sloan Kettering Canc Ctr, Myeloma Serv, Div Hematol Oncol, 1275 York Ave, New York, NY 10021 USA
基金
美国国家卫生研究院;
关键词
QUANTITATIVE COMPUTED-TOMOGRAPHY; GENE/ENVIRONMENT SUSCEPTIBILITY-REYKJAVIK; MULTIPLE-MYELOMA; FRACTURE RISK; MINERAL DENSITY; VERTEBRAL FRACTURES; HIP-FRACTURES; PREVALENCE; OSTEOPOROSIS; MGUS;
D O I
10.1182/bloodadvances.2017010454
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Previous studies have shown that individuals with monoclonal gammopathy of undetermined significance (MGUS) have an increased risk of fractures, although the underlying mechanisms remain unknown. Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS. We performed a screening using the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study cohort, consisting of 5764 elderly individuals, identifying 300 individuals with MGUS, and 275 with light-chain MGUS. Quantitative computerized tomography was performed in the lumbar spine and hip to evaluate BMD and bone geometry. Analysis of variance and the Tukey honest significance test were used to compare the groups. Hospital records were used to record fractures, with a mean follow-up of 6.9 years. Cox proportional hazard was used to compare fracture risk. No difference was found in BMD between subjects with MGUS and others in the spine (P = .34) or in total hip (P = .30). Individuals with MGUS had a significant increase in bone volume compared with others in the spine(P < .001) and total hip (P,.001). Overall, the risk of fractures was not significantly increased in individuals with MGUS (hazard ratio [HR], 1.19; 95% confidence interval [CI], 0.94-1.50). Men with MGUS had a significantly increased fracture risk, compared with other men (HR, 1.46; 95% CI, 1.03-2.08). Our results show that although individuals with MGUS do not have decreased BMD, bone volume is increased, and MGUS men have a 50% increased fracture risk. These results indicate that bone disease and fractures in MGUS differ from processes known from osteoporosis.
引用
收藏
页码:2790 / 2798
页数:9
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