Lumbar bone mineral density as the major factor determining increased prevalence of vertebral fractures in monoclonal gammopathy of undetermined significance

Abstract

) were lower (all P £ 0AE001) in Fx-MGUS compared with Nfx patients. Receiver operating characteristic curves identified lumbar BMD as the variable that best predicted vertebral fractures (area under the curve 0AE817; 95% confidence interval, 0AE713-0AE921). This study provides an indication for the measurement of BMD in MGUS patients, as a means of predicting vertebral fractures, especially in those that are asymptomatic. Patients with prevalent fractures should undergo pharmacological treatment to prevent further fractures.

Prevalence of subclinical contributors to low bone mineral density and/or fragility fracture

“…This is important since it seems to be associated with an increased fracture risk (46,47,48). Finally, we made no diagnosis of rheumatologic disease.…”

“…To overcome this limitation, the prevalence of the subclinical contributors to low BMD and/or fragility fracture was reported even without considering hypovitaminosis D. Another limit of the present study may be that its protocol is hardly transferable in the clinical practice for because of the high cost. However, it must be noted that the biochemical workup we performed, with the exception of PTH, 25OHVitD, TSH, 1-mg DST, and IgA antitissue transglutaminase and endomysial, is considered the routine first-line testing in patients with reduced BMD and/or fragility fracture (48). On the basis of the present data, in addition to the first-line evaluations, the 25OHVitD levels assessment seems mandatory in all patients with low BMD and/or a fragility fracture, at least in Italy.…”

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

“…Furthermore, there was a higher risk for axial (skull, vertebral/pelvis, and sternum/costae) compared with distal (arm and leg) Submitted fractures. 4 Results from other published studies on fractures in MGUS patients [5][6][7][8] have shown 1.4-to 6.3-fold increased risk of fractures in MGUS patients. Researchers have found a high prevalence of MGUS in osteoporotic patients, [9][10][11][12] which has led some authors to suggest that protein electrophoresis should always be performed as screening for MGUS (and MM) in patients with osteoporosis and/or fractures.…”

Monoclonal gammopathy of undetermined significance and risk of skeletal fractures: a population-based study

“…4 Although patients with MGUS are asymptomatic, they may have increased morbidity and mortality. [5][6][7] Previous smaller studies found that patients with MGUS have an increased risk of fractures, 2,5,8,9 and that the prevalence of MGUS is high in patients with osteoporosis [9][10][11] ; however, it is unclear whether this is associated with MM transformation or related to MGUS per se. On the basis of small numbers, patterns of fracture risk in relation to MGUS immunoglobulin (Ig) isotype and concentration of the monoclonal (M) protein concentration are inconsistent.…”