Bone tissue quality in patients with monoclonal gammopathy of uncertain significance
Orduna Erbetta, Guillermina (Hospital del Mar (Barcelona, Catalunya))
Leonardo, Mellibovsky (Hospital del Mar (Barcelona, Catalunya))
Abella Monreal, Eugenia (Hospital del Mar (Barcelona, Catalunya))
Nogués Solán, Xavier (Hospital del Mar (Barcelona, Catalunya))
Granero, Roser (Universitat Autònoma de Barcelona. Departament de Psicobiologia i de Metodologia de les Ciències de la Salut)
Garcia-Giralt, Natalia (Hospital del Mar (Barcelona, Catalunya))
Pineda-Moncusí, Marta (Hospital del Mar (Barcelona, Catalunya))
Güerri-Fernández, Robert (Hospital del Mar (Barcelona, Catalunya))
Prieto-Alhambra, Daniel (University of Oxford)
Díez Pérez, Adolfo (Hospital del Mar (Barcelona, Catalunya))
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2020
Descripció:	15 pàg.
Resum:	Introduction: Monoclonal gammopathy of uncertain significance (MGUS) is highly prevalent in older adults and affects bone structure, with osteoporosis and increased risk of fractures in up to 14% of affected patients. Dual-energy X-ray absorptiometry (DXA), the standard technique for diagnosing osteoporosis, is ineffective to reveal microstructure and bone quality in this disease. Materials and methods: We conducted a cross-sectional study of patients with MGUS, recruited consecutively from the Hematology and Internal Medicine Departments of Hospital del Mar, Barcelona, between January 2011 and January 2018. Medical records, clinical results and spinal X-ray images were collected. Bone mineral density (BMD) at hip and spine was measured by DXA and Bone Material Strength index (BMSi) by impact microindentation on the tibial mid-shaft. Results: Thirty-nine patients with MGUS and 65 age-matched controls without previous fractures were included. In the MGUS group, 11 (28. 2%) patients had prevalent fractures, nearly half of them vertebral (n = 5, 45. 45%). Compared to controls, MGUS patients had significantly lower BMSi, a mean (SD) of 70. 72 (9. 70) vs. 78. 29 (8. 70), p = 0. 001, and lower spinal BMD values (0. 900 [0. 159] vs. 1. 003 [0. 168], respectively, p = 0. 012), but no significant differences at femoral neck and total hip. No association was observed between BMSi and DXA. Bone remodeling markers (procollagen type-1 N propeptide, bone-alkaline phosphatase and C-terminal telopeptide of type I collagen) did not differ between the two groups. Conclusions: Spinal BMD and mechanical properties of bone tissue, as measured by impact microindentation, were impaired in patients with MGUS. These changes in bone tissue mechanical resistance were independent of DXA levels.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Bone microindentation ; Bone quality ; DXA ; Monoclonal gammopathy of uncertain significance ; Body Mass Index ; Bone Density ; Humans ; Male ; Case-Control Studies ; Monoclonal Gammopathy of Undetermined Significance/physiopathology ; Bone and Bones/physiopathology ; Female ; Aged ; SDG 3 - Good Health and Well-being
Publicat a:	Journal of Bone and Mineral Metabolism, Vol. 38, Núm. 4 (2020) , p. 563-569, ISSN 1435-5604

DOI: 10.1007/s00774-020-01084-3
PMID: 31974675

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