| Objective: To evaluate the significance of serum bone metabolism markers(BTMs)β-CTX,P1 NP,N-MIND,PTH,2 and 5dihydroxyvitamin-D3 in patients with multiple myeloma(MM).Methods: Fifty-three patients with MM in the Department of Hematology of the First Hospital of Qinhuangdao were selected as the study subjects.Of these,35 were newly diagnosed and 48 returned.The clinical data included age,gender,various blood and urine examinations,peripheral blood smear examinations,bone marrow-related examinations,and various imaging examinations,and BTMs included serum carboxy-terminal extended peptide of type I collagen(β-CTX),amino-terminal extended peptide of type I collagen(P1NP),bone calcitonin N-terminal middle molecule(OCN-MID),parathyroid hormone(PTH),and 2,5 dihydroxyvitamin-D3(2,5(OH)2-D3)contents.Statistical analysis: 1.To evaluate the significance of BTMs in gender,age,type,clinical stage and clinical manifestations of MM.2,to assess the significance of BTMs in different grades of MBD.3,to assess the correlation and significance between MM-related test items or combination items and BTMs.4,to assess the prognostic significance of BTMs in MM and MBD.Results: Results: 1.35 newly diagnosed MM patients,19 males(54.3%),16 females(45.7%);21 Ig G type(60%),7 light chain type(20%),4 Ig D type(11.4%),3 Ig A type(8.6%);29 bone disease onset(82.9%),3 anemia(8.6%),2 hypercalcemia(5.6%),1 vomiting(2.9%);18 DS stage III(51.4%),10 stage I(28.6%),7 stage II(20%);13 ISS stage II(37.1%),10 stage I(28.6%),12 stage III(34.3%);11 MBD grade 4(31.4%),7 grade 1(20%),7 grade 3(20%),6 grade 2(17.1%),4 grade 0(11.5%);16 MBD sites There were 7cases(22.6%)of ribs,5 cases(16.1%)of pelvis and 3 cases(9.7%)of skull;24 cases(68.6%)of MM anemia and 11 cases(31.4%)of no anemia;in MBD grade,Hb(g/L)was 110.25 ± 22.44,99.94 ± 24.93 and 93.95 ± 27.74 andβ2-MG(mg/ml)was 3.34 ± 7.31,7.30 ± 3.61 and 13.02 ± 6.36 in grade 0-1,2-3 and 4 patients,respectively,Serum creatinine(μmol/L)was 75.37 ± 25.18,102.24 ± 45.80,and 147.75 ± 156.65,lactate dehydrogenase(U/L)was182.83 ± 42.59,174.42 ± 27.32,and 184.17 ± 22.5,plasma cell number% was14.86 ± 6.25,23.56 ± 10.79,and 47.62 ± 19.91,and serum calcium(mmol/L)was 2.27 ± 0.39,2.18 ± 0.16,and 2.78 ± 0.53,respectively.BTMs results:(1)β-CTX: the mean value of males was higher than that of females,and the difference was not statistically significant(P > 0.05);there was no significant difference between different age groups(P > 0.05);Ig D type was significantly higher than Ig G type and light chain type,and the difference was statistically significant(P < 0.05);there was no significant difference between Ig D type and Ig A type and Ig A,Ig G type and light chain type;there was no significant difference between DS stage;the mean value of ISS stage I and II was significantly lower than that of stage III,and the difference was statistically significant(P < 0.05),and there was no significant difference between stage I and II;the mean value of MBD grade 0,1,and 2was significantly lower than that of grade 3 and 4,and there was significant difference between grade 0,1,2 and 4(P < 0.05),but there was no significant difference between grade 0,1,and 2 and 3(P > 0.05).There were no significant differences in pairwise comparisons between grades 3 and 4 and between grades 0,1,and 2;according to Pearson correlation analysis,there were positive correlations with serum calcium,serum creatinine,and plasma cell number after correction or not(P < 0.05).(2)2,5(OH)2-D3,P1 NP,N-MIND and PTH: The mean values of 2 and 5 dihydroxyvitamin-D3,NMID and PTH in male patients were higher than those in female patients,and the difference was not statistically significant(P < 0.05).The mean value of P1 NP in male patients was lower than that in female patients,and the difference was not statistically significant(P > 0.05).There was no significant difference in P1 NP,N-MIND,PTH,2 and 5(OH)2-D3 between different age groups(P > 0.05).The mean values of 2 and 5(OH)2-D3 in moderate MM anemia group were higher than those in mild anemia group,and there was no significant difference between mild anemia group and moderate anemia group(P > 0.05).There were no significant differences in pairwise comparisons of P1 NP,N-MIND,and PTH among the groups without anemia,mild anemia,and moderate anemia(P > 0.05);there were no significant differences in P1 NP,N-MIND,PTH,2,and 5(OH)2-D3 among MM types,DS stages,ISS stages,and MBD grades(P > 0.05);there was a positive correlation between 2and 5(OH)2-D3 and serum calcium or corrected serum calcium and plasma cell number(%)(P < 0.05);there was a negative relationship between PTH and serum calcium and plasma cell number(P < 0.05);and there was no correlation between P1 NP,N-MIND,PTH and corrected serum calcium,serum creatinine,and plasma cell number.According to Pearson correlation analysis,the number(%)of plasma cells and the mean value of β2 microglobulin in patients with MBD grade 2-4were higher than those in patients with grade 0-1,and the difference was statistically significant(P < 0.01).The corrected or uncorrected serum calcium in patients with MBD4 was higher than that in patients with grade1-2,and the difference was statistically significant(P < 0.05).There was no significant difference in the indicators of hemoglobin,serum creatinine and lactate dehydrogenase levels between patients at all levels(P > 0.05).There was a negative correlation between hemoglobin and the number of plasma cells(P < 0.05).There was a negative correlation between β2-MG and hemoglobin,corrected or uncorrected serum calcium(P > 0.05),and a positive correlation between β2-MG and the number(%)of plasma cells and serum creatinine(P > 0.05).CONCLUSION:(1)There are significant differences between β-CTX and MM type,ISS stage,MBD grade and MRD level,and there are significant positive correlations with corrected or uncorrected serum calcium,serum creatinine and plasma cell count.There is no significant difference with gender,age,DS stage,MBD imaging remission degree and myeloma efficacy evaluation.It is significant in evaluating MM type,disease condition,prognosis and MBD grade.2There was no difference between P1 NP,N-MIND,PTH,2,and 5(OH)2-D3 and MM type,DS stage,ISS stage,MBD imaging response,myeloma efficacy evaluation,MRD level,and MBD grade,and the mean values of 2 and 5(OH)2-D3 in the moderate anemia group were higher than those in the mild anemia group,and the gap was statistically significant,which was positively correlated with serum calcium or corrected serum calcium and plasma cell number(%)(P < 0.05);there was a negative relationship between PTH and serum calcium and plasma cell number(P <0.05),which was less significant in assessing MM and MBD disease. |
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