文章：

意义未明的单克隆丙种球蛋白病患者发生椎骨骨折相关危险因素分析

Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

原文发布日期：2015-08-28

DOI: 10.1038/bcj.2015.71

类型: Original Article

开放获取: 是

英文摘要：

Monoclonal gammopathies of undetermined significance (MGUS) have been shown to be associated with an increased risk of fractures. This study describes prospectively the bone status of MGUS patients and determines the factors associated with vertebral fracture. We included prospectively 201 patients with MGUS, incidentally discovered, and with no known history of osteoporosis: mean age 66.6±12.5 years, 48.3% women, 51.7% immunoglobulin G (IgG), 33.3% IgM and 10.4% IgA. Light chain was kappa in 64.2% patients. All patients had spinal radiographs and bone mineral density measurement in addition to gammopathy assessment. At least one prevalent non-traumatic vertebral fracture was discovered in 18.4% patients and equally distributed between men and women. Fractured patients were older, had a lower bone density and had also more frequently a lambda light chain isotype. Compared with patients with κ light chain, the odds ratio of being fractured for patients with λ light chain was 4.32 (95% confidence interval 1.80–11.16; P=0.002). These results suggest a high prevalence of non-traumatic vertebral fractures in MGUS associated with lambda light chain isotype and not only explained by low bone density.

摘要翻译： 

意义未明的单克隆丙种球蛋白病（MGUS）已被证实与骨折风险增加相关。本研究前瞻性描述了MGUS患者的骨骼状况，并确定了与椎体骨折相关的因素。我们前瞻性纳入了201例偶然发现、无已知骨质疏松病史的MGUS患者：平均年龄66.6±12.5岁，女性占48.3%，免疫球蛋白G（IgG）型占51.7%，IgM型占33.3%，IgA型占10.4%。64.2%患者为κ轻链型。所有患者除进行丙种球蛋白评估外，均接受脊柱X光检查和骨密度测量。18.4%患者发现至少一处非创伤性椎体骨折，男女分布均衡。骨折患者年龄更大、骨密度更低，且λ轻链亚型出现频率更高。与κ轻链患者相比，λ轻链患者的骨折比值比为4.32（95%置信区间1.80-11.16；P=0.002）。这些结果表明非创伤性椎体骨折在MGUS患者中普遍存在，且与λ轻链亚型相关，不能仅用低骨密度解释。

原文链接：

Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance