title: Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance.
abstract: 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.
authors: Department of Rheumatology, Angers University Hospital, Angers, France.
authors: J M
authors: JM
authors: Piot
authors: Department of Rheumatology, Angers University Hospital, Angers, France.
authors: M
authors: M
authors: Royer
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: A
authors: A
authors: Schmidt-Tanguy
authors: Department of Rheumatology, Angers University Hospital, Angers, France.
authors: E
authors: E
authors: Hoppé
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: M
authors: M
authors: Gardembas
authors: Department of Rheumatology, Angers University Hospital, Angers, France.
authors: T
authors: T
authors: Bourrée
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: M
authors: M
authors: Hunault
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: S
authors: S
authors: François
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: F
authors: F
authors: Boyer
authors: Department of Hematology, INSERM U892/CNRS 6299, Angers University Hospital, Angers, France.
authors: N
authors: N
authors: Ifrah
authors: Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France.
authors: G
authors: G
authors: Renier
authors: Laboratory of Immunology and Allergology, Angers University Hospital, Angers, France.
authors: A
authors: A
authors: Chevailler
authors: Department of Rheumatology, Angers University Hospital, Angers, France.|GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: M
authors: M
authors: Audran
authors: GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: D
authors: D
authors: Chappard
authors: GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: H
authors: H
authors: Libouban
authors: GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: G
authors: G
authors: Mabilleau
authors: Department of Rheumatology, Angers University Hospital, Angers, France.|GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: E
authors: E
authors: Legrand
authors: Department of Rheumatology, Angers University Hospital, Angers, France.|GEROM Research Group on Bone Remodeling and bioMaterials, UPRES EA 4658, University Hospital, Angers, France.
authors: B
authors: B
authors: Bouvard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications* / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*