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

Sigrun Thorsteinsdottir, Sigrun H. Lund, Ebba K. Lindqvist, Marianna Thordardottir, Gunnar Sigurdsson, Rene Costello, Debra Burton, Hlif Steingrimsdottir, Vilmundur Gudnason, Gudny Eiriksdottir, Kristin Siggeirsdottir, Tamara B. Harris, Ola Landgren, Sigurdur Y. Kristinsson

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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 fractureswas not significantly increased in individualswithMGUS (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.

Original languageEnglish (US)
Pages (from-to)2790-2798
Number of pages9
JournalBlood Advances
Volume1
Issue number27
DOIs
StatePublished - Dec 26 2017
Externally publishedYes

ASJC Scopus subject areas

  • Hematology

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