Changes Of Serum Uric Acid Levels In Multiple Myeloma And Analysis Of Related Factors

Objective:To analyze the changes of serum uric acid levels in patients with multiple myeloma and its related influencing factors,so as to provide reference for further exploration of the mechanism and harm of abnormal uric acid metabolism in humans.Methods:From March 2015 to January 2018,75 patients with multiple myeloma were diagnosed in The second Affiliated Hospital of Kunming Medical University.Among them,36 patients with renal insufficiency were group A and 39 patients with non-renal insufficient patients were group B.The patient’s sex,age,and clinical data were recorded.Check patient’s serum uric acid(UA)、urea(UREA)、creatinine(CREA)、albumin(ALB)、calcium(CA)、Cystatin C(Cys C)、serum кlight chain(serum к-LC)and serum λ light chain(serum λ-LC),uric K light chain(uric к-LC),uric λ light chain(uric λ-LC)、uric al microglobulin(AIM)uric immunoglobulin G(IgU)、uric microalbumin(MA)、uric N-acetyl-β-D-glucosaminidase(NAG)、uric transferrin(TRU)and uric 24-hours proteinuria(24hPro)values.After statistical analysis,to investigate the characteristics of changes in serum uric acid levels in patients with multiple myeloma,and whether there is any difference in serum uric acid levels between patients with different immunophenotypes and the correlation between serum uric acid levels and other biochemical markers in patients with multiple myeloma renal insufficiency.Results:Serum UA level was(533.22 ± 175.63)μmol/L in multiple myeloma renal insufficiency patients(Group A),and serum UA level was(390.08 ±159.03)P mol/L in multiple myeloma non-renal insufficiency patients(Group B).The difference between the two groups was statistically significant(t=3.410,P<0.01).There were 29 cases of hyperuricemia in group A(80.6%);there were 19 cases of hyperuricemia in group B(48.7%).In comparison among different M protein groups,serum UA levels in patients with Dufie-Salmin stage III are higher than those in stage II and stage I patients,and serum UA levels in patients with IgG stage III were higher than those in other groups at the same stage.In group A,serum UA levels in IgA кpatients was(530.0±90.39)μmol/L,serum UA levels in IgAλpatients was(504.0 ± 37.49)μ mol/L,serum UA levels in IgG к patients was(635.0±151.25)μmol/L,serum UA levels in IgG λ patients was(522.6 ± 152.19)μ mol/L,serum UA levels in IgD λ patients was(478.0 ± 151.13)μmol/L,serum UA levels in double cloning patient was(376.0)μmol/L,serum UA level in к-type patients was(468.0± 160.65)μmol/L,and the serum UA level in λ-type patients was(602.17±151.47)μmol/L;statistical differences between groups were tested using a one-way analysis of variance,there was no difference among groups(F=0.817,P>0.05).In group B,serum U A levels in IgA кpatients was 303(224.5,539.5)μmol/L,serum UA levels in IgAλ patients was 209(189,381.5)μ mol/L,serum UA levels in IgGкpatients was(365.5 ± 147.1)μmol/L,serum UA levels in IgGλpatients was(405.8 ± 121.4)μmol/L,serum UA levels in IgDλ patient was(537.0)μmol/L,serum UA levels in double cloning patient was(457.0)P mol/L,serum UA levels inкpatients was(397.3 ± 105.8)μmol/L and the serum UA level in λ-type patients was 412(314.5,509.5)μ mol/L;Kruskal-Wallis H analysis was used for the comparison between the groups.There was no difference among the groups(H= 0.273,P>0.05).According to the analysis of the influencing factors of renal insufficiency,univariate logistic regression was performed according to gender,type,stage,HUA,hypercalcemia,proteinuria,staging,HUA,and hypercalcemia were statistically significant(P<0.05).Analysis of the influencing factors of the prognosis of 75 patients,according to gender,classification,staging,renal insufficiency,HUA,hypercalcemia,proteinuria,univariate Logistic regression,staging,renal insufficiency,with HUA statistically significant(P<0.05).In group A serum UA levels were highly positively correlated with serum levels of к-LC,λ-LC,and Cys C(r=0.771,0.517,0.800,P<0.01);were highly positively correlated with urinary AIM,urinary IgU,urinary MA,urinary NAG,Urinary 24hPro levels(r = 0.714,0.822,0.712,0.76,0.59,P<0.01);were positive correlation with urinary TRU levels(r = 0.331,P<0.05);were negative correlation with urinary к-LC,λ-LC levels(r =-0.390,-0.354,P<0.05);there were no correlation with serum UREA,CREA and ALB(r = 0.128,0.168,0.085,P>0.05).Conclusions:Serum uric acid levels are increase in multiple myeloma with renal insufficiency patients;there was no significant difference in serum uric acid levels among different types of immunophenotypes of myeloma;abnormal uric acid metabolism in multiple myeloma with renal insufficiency patients may be related to glomerular injury,renal tubular injury,tumor burden;the uric acid level in multiple myeloma with renal insufficiency patients kept in the normal range is great significance for prognosis.