BONE DISEASE IN MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE:RESULTS FROM A SCREENED POPULATION-BASED STUDY
(Abstract release date: 05/19/16)
EHA Library. Thorsteinsdóttir S. 06/09/16; 132807; E1258
Dr. Sigrún Thorsteinsdóttir
Contributions
Contributions
Abstract
Abstract: E1258
Type: Eposter Presentation
Background
Monoclonal gammopathy of unknown significance (MGUS) is a precursor condition that precedes multiple myeloma (MM). Bone disease is a major manifestation of MM, and includes osteolytic lesions, fractures, and osteoporosis. Previous population-based studies have shown that individuals with MGUS have an increased risk of fractures, although the mechanism behind this increased risk remains unknown. Furthermore, these studies have been performed on clinically established cohorts with a risk of bias due to underlying comorbidity.
Aims
Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS in a screened population.
Methods
We performed a screening for MGUS in the Age Gene/Environment Susceptibility Reykjavik study (AGES-Reykjavik) cohort, consisting of 5,764 elderly Icelandic men and women. Through serum protein electrophoresis and free light chain analyses, 300 individuals with MGUS (159 men and 141 women) and 52 individuals with light chain MGUS (LC-MGUS; 35 men and 18 women) were identified. Quantitative computerized tomography (QCT) was performed in the lumbar spine (L1/L2), hip and mid-femoral shaft to evaluate cortical, trabecular and integral BMD as well as bone geometry in all individuals. Analysis of variance and Tukey's honest significance test were used to compare individuals with MGUS and LC-MGUS with others. Hospital records with International Classification of Diseases were used to record fractures from the individuals’ enrollment into the study with a mean follow up time of 6.9 years. Cox proportional hazard models were used to compare risk of fractures in MGUS and others. Results were adjusted for age and sex.
Results
No difference was found in BMD between subjects with MGUS and others at the spine (Table 1; mean for MGUS (MMGUS)=0.197 mg/cm3, mean for others (Mothers)=0.194 mg/cm3, p=0.21) or total hip (MMGUS=0.239 mg/cm3, Mothers=0.237 mg/cm3, p=0.22). Volumetric measurements showed that individuals with MGUS had a statistically significant increase in bone volume compared to others in the lumbar spine (MMGUS=41.5 cm3, Mothers=39.7 cm3, p<0.001) and total hip (MMGUS=106.3 cm3, Mothers=100.1 cm3, p<0.001). A significant difference was found in bone volume in total hip in MGUS men, compared to other men (MMGUS=123.6 cm3, Mothers=119.3 cm3, p=0.04). Overall, the risk of fractures was not increased in individuals with MGUS as compared to others (hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.94-1.50). Men with MGUS had a significantly increased risk of fractures, compared to other men (HR: 1.49; 95% CI: 1.05-2.12).
Conclusion
Our results from a screened population show that individuals with MGUS do not have a decreased BMD at the lumbar spine or hip. Surprisingly, however, we find that bone volume is increased in individuals with MGUS, especially in men, who also have an increased risk of fractures. This suggests an effect of MGUS on bone metabolism in men that is not noted in women, probably as a result of other stronger risk factors in women. Further reaserch is needed to explain the increased bone volume in men with MGUS.
Session topic: E-poster
Keyword(s): Bone disease, Bone mineral density, MGUS
Type: Eposter Presentation
Background
Monoclonal gammopathy of unknown significance (MGUS) is a precursor condition that precedes multiple myeloma (MM). Bone disease is a major manifestation of MM, and includes osteolytic lesions, fractures, and osteoporosis. Previous population-based studies have shown that individuals with MGUS have an increased risk of fractures, although the mechanism behind this increased risk remains unknown. Furthermore, these studies have been performed on clinically established cohorts with a risk of bias due to underlying comorbidity.
Aims
Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS in a screened population.
Methods
We performed a screening for MGUS in the Age Gene/Environment Susceptibility Reykjavik study (AGES-Reykjavik) cohort, consisting of 5,764 elderly Icelandic men and women. Through serum protein electrophoresis and free light chain analyses, 300 individuals with MGUS (159 men and 141 women) and 52 individuals with light chain MGUS (LC-MGUS; 35 men and 18 women) were identified. Quantitative computerized tomography (QCT) was performed in the lumbar spine (L1/L2), hip and mid-femoral shaft to evaluate cortical, trabecular and integral BMD as well as bone geometry in all individuals. Analysis of variance and Tukey's honest significance test were used to compare individuals with MGUS and LC-MGUS with others. Hospital records with International Classification of Diseases were used to record fractures from the individuals’ enrollment into the study with a mean follow up time of 6.9 years. Cox proportional hazard models were used to compare risk of fractures in MGUS and others. Results were adjusted for age and sex.
Results
No difference was found in BMD between subjects with MGUS and others at the spine (Table 1; mean for MGUS (MMGUS)=0.197 mg/cm3, mean for others (Mothers)=0.194 mg/cm3, p=0.21) or total hip (MMGUS=0.239 mg/cm3, Mothers=0.237 mg/cm3, p=0.22). Volumetric measurements showed that individuals with MGUS had a statistically significant increase in bone volume compared to others in the lumbar spine (MMGUS=41.5 cm3, Mothers=39.7 cm3, p<0.001) and total hip (MMGUS=106.3 cm3, Mothers=100.1 cm3, p<0.001). A significant difference was found in bone volume in total hip in MGUS men, compared to other men (MMGUS=123.6 cm3, Mothers=119.3 cm3, p=0.04). Overall, the risk of fractures was not increased in individuals with MGUS as compared to others (hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.94-1.50). Men with MGUS had a significantly increased risk of fractures, compared to other men (HR: 1.49; 95% CI: 1.05-2.12).
Conclusion
Our results from a screened population show that individuals with MGUS do not have a decreased BMD at the lumbar spine or hip. Surprisingly, however, we find that bone volume is increased in individuals with MGUS, especially in men, who also have an increased risk of fractures. This suggests an effect of MGUS on bone metabolism in men that is not noted in women, probably as a result of other stronger risk factors in women. Further reaserch is needed to explain the increased bone volume in men with MGUS.
Session topic: E-poster
Keyword(s): Bone disease, Bone mineral density, MGUS
Abstract: E1258
Type: Eposter Presentation
Background
Monoclonal gammopathy of unknown significance (MGUS) is a precursor condition that precedes multiple myeloma (MM). Bone disease is a major manifestation of MM, and includes osteolytic lesions, fractures, and osteoporosis. Previous population-based studies have shown that individuals with MGUS have an increased risk of fractures, although the mechanism behind this increased risk remains unknown. Furthermore, these studies have been performed on clinically established cohorts with a risk of bias due to underlying comorbidity.
Aims
Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS in a screened population.
Methods
We performed a screening for MGUS in the Age Gene/Environment Susceptibility Reykjavik study (AGES-Reykjavik) cohort, consisting of 5,764 elderly Icelandic men and women. Through serum protein electrophoresis and free light chain analyses, 300 individuals with MGUS (159 men and 141 women) and 52 individuals with light chain MGUS (LC-MGUS; 35 men and 18 women) were identified. Quantitative computerized tomography (QCT) was performed in the lumbar spine (L1/L2), hip and mid-femoral shaft to evaluate cortical, trabecular and integral BMD as well as bone geometry in all individuals. Analysis of variance and Tukey's honest significance test were used to compare individuals with MGUS and LC-MGUS with others. Hospital records with International Classification of Diseases were used to record fractures from the individuals’ enrollment into the study with a mean follow up time of 6.9 years. Cox proportional hazard models were used to compare risk of fractures in MGUS and others. Results were adjusted for age and sex.
Results
No difference was found in BMD between subjects with MGUS and others at the spine (Table 1; mean for MGUS (MMGUS)=0.197 mg/cm3, mean for others (Mothers)=0.194 mg/cm3, p=0.21) or total hip (MMGUS=0.239 mg/cm3, Mothers=0.237 mg/cm3, p=0.22). Volumetric measurements showed that individuals with MGUS had a statistically significant increase in bone volume compared to others in the lumbar spine (MMGUS=41.5 cm3, Mothers=39.7 cm3, p<0.001) and total hip (MMGUS=106.3 cm3, Mothers=100.1 cm3, p<0.001). A significant difference was found in bone volume in total hip in MGUS men, compared to other men (MMGUS=123.6 cm3, Mothers=119.3 cm3, p=0.04). Overall, the risk of fractures was not increased in individuals with MGUS as compared to others (hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.94-1.50). Men with MGUS had a significantly increased risk of fractures, compared to other men (HR: 1.49; 95% CI: 1.05-2.12).
Conclusion
Our results from a screened population show that individuals with MGUS do not have a decreased BMD at the lumbar spine or hip. Surprisingly, however, we find that bone volume is increased in individuals with MGUS, especially in men, who also have an increased risk of fractures. This suggests an effect of MGUS on bone metabolism in men that is not noted in women, probably as a result of other stronger risk factors in women. Further reaserch is needed to explain the increased bone volume in men with MGUS.
Session topic: E-poster
Keyword(s): Bone disease, Bone mineral density, MGUS
Type: Eposter Presentation
Background
Monoclonal gammopathy of unknown significance (MGUS) is a precursor condition that precedes multiple myeloma (MM). Bone disease is a major manifestation of MM, and includes osteolytic lesions, fractures, and osteoporosis. Previous population-based studies have shown that individuals with MGUS have an increased risk of fractures, although the mechanism behind this increased risk remains unknown. Furthermore, these studies have been performed on clinically established cohorts with a risk of bias due to underlying comorbidity.
Aims
Our aim was to analyze bone mineral density (BMD), bone volume, and risk of fractures among individuals with MGUS in a screened population.
Methods
We performed a screening for MGUS in the Age Gene/Environment Susceptibility Reykjavik study (AGES-Reykjavik) cohort, consisting of 5,764 elderly Icelandic men and women. Through serum protein electrophoresis and free light chain analyses, 300 individuals with MGUS (159 men and 141 women) and 52 individuals with light chain MGUS (LC-MGUS; 35 men and 18 women) were identified. Quantitative computerized tomography (QCT) was performed in the lumbar spine (L1/L2), hip and mid-femoral shaft to evaluate cortical, trabecular and integral BMD as well as bone geometry in all individuals. Analysis of variance and Tukey's honest significance test were used to compare individuals with MGUS and LC-MGUS with others. Hospital records with International Classification of Diseases were used to record fractures from the individuals’ enrollment into the study with a mean follow up time of 6.9 years. Cox proportional hazard models were used to compare risk of fractures in MGUS and others. Results were adjusted for age and sex.
Results
No difference was found in BMD between subjects with MGUS and others at the spine (Table 1; mean for MGUS (MMGUS)=0.197 mg/cm3, mean for others (Mothers)=0.194 mg/cm3, p=0.21) or total hip (MMGUS=0.239 mg/cm3, Mothers=0.237 mg/cm3, p=0.22). Volumetric measurements showed that individuals with MGUS had a statistically significant increase in bone volume compared to others in the lumbar spine (MMGUS=41.5 cm3, Mothers=39.7 cm3, p<0.001) and total hip (MMGUS=106.3 cm3, Mothers=100.1 cm3, p<0.001). A significant difference was found in bone volume in total hip in MGUS men, compared to other men (MMGUS=123.6 cm3, Mothers=119.3 cm3, p=0.04). Overall, the risk of fractures was not increased in individuals with MGUS as compared to others (hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.94-1.50). Men with MGUS had a significantly increased risk of fractures, compared to other men (HR: 1.49; 95% CI: 1.05-2.12).
Conclusion
Our results from a screened population show that individuals with MGUS do not have a decreased BMD at the lumbar spine or hip. Surprisingly, however, we find that bone volume is increased in individuals with MGUS, especially in men, who also have an increased risk of fractures. This suggests an effect of MGUS on bone metabolism in men that is not noted in women, probably as a result of other stronger risk factors in women. Further reaserch is needed to explain the increased bone volume in men with MGUS.
Session topic: E-poster
Keyword(s): Bone disease, Bone mineral density, MGUS
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