title: Bone remodelling in monoclonal gammopathies of uncertain significance, symptomatic and nonsymptomatic myeloma.
abstract: In order to characterize the abnormalities of bone remodelling in the various stages of plasma cell disorders, we studied 60 patients (29 monoclonal gammopathies of uncertain significance (MGUS), 13 stage I myeloma, 18 stage III myeloma). We carried out histomorphometric study of bone biopsies in 34 patients and measurement of osteocalcin and the calciuria/creatinine ratio. Bone remodelling was approximately normal (BV/TV:21.2 +/- 7, ES:4.1 +/- 2, OS:16.5 +/- 10) in MGUS. Stage I myeloma was characterised by parallel increases in resorption surfaces and osteoid surfaces (BV/TV:18 +/- 5, ES/BS:7.4 +/- 3.5, OS/BS:24.8 +/- 11.5), of the ca/cr ratio and osteocalcin. In stage III myeloma, resorption surfaces and the ca/cr ratio showed an even greater increase while osteoid surfaces, osteocalcin and trabecular bone volume decreased (BV/TV 13.6 +/- 6, ES/BS:12.1 +/- 6, OS/BS:13.6 +/- 8.3). Osteocalcin and osteoid surfaces were correlated (r = 0.5). There was a positive correlation between osteocalcin and the number of plasmocytes in stage 1 myeloma (r = 0.64) and a negative correlation in stage III myeloma (r = 0.9). Bone remodeling was normal in MGUS; bone remodelling grew with a parallel increase of formation and resorption in stage I; bone resorption increased while bone formation decreased in stage III myeloma.
authors.affiliation: Service de Rhumatologie, CHU Rangueil Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Laroche
authors.forename: M
authors.initials: M
authors.lastname: Attal
authors.forename: C
authors.initials: C
authors.lastname: Dromer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001847:Bone Diseases / Q000503:physiopathology; D016723:Bone Remodeling / Q000502:physiology*; D002118:Calcium / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D009367:Neoplasm Staging; D015675:Osteocalcin / Q000378:metabolism; D010265:Paraproteinemias / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D011446:Prospective Studies; D011863:Radioimmunoassay
chemical_list: D015415:Biomarkers; D015675:Osteocalcin; D003404:Creatinine; D002118:Calcium