Monoclonal gammopathy of undetermined significance and bone well being outcomes: a scientific assessment and exploratory meta-analysis.
J Bone Miner Metab. 2018 Jan;36(1):128-132
Authors: Veronese N, Luchini C, Solmi M, Sergi G, Manzato E, Stubbs B
Monoclonal gammopathy of undetermined significance (MGUS) is a standard situation within the aged. Plenty of research have investigated the connection between MGUS and bone well being outcomes together with bone mineral density (BMD), osteoporosis and fractures, however no meta-analysis exists. We performed a scientific assessment and exploratory meta-analysis evaluating bone well being outcomes in sufferers with MGUS. Two unbiased authors searched PubMed and Scopus from inception till 19 October 2016. A meta-analysis of cross-sectional and longitudinal research investigating fractures and BMD was performed. Standardised imply variations (SMD) ± 95% confidence intervals (CIs) have been calculated for BMD, and danger ratios (RRs) have been calculated for prevalent and incident fractures. Of 174 preliminary hits, 10 research of reasonable methodological high quality have been eligible, together with 8711 people with MGUS vs. 52,865 controls. In comparison with controls, topics with MGUS confirmed considerably decrease values for radial cortical volumetric BMD (1 research; SMD = -5.45, 95% CI: -7.24 to -Three.66), however not on the lumbar backbone, femoral neck or hip. The incidence of fractures was greater in folks with MGUS (n = 7466) vs. controls (n = 52,304) (RR = 1.36, 95% CI 1.28-1.44, I 2 = zero%) over a median of 12.5-year follow-up. The incidence of vertebral fractures was notably elevated (RR = 2.50, 95% CI 1.53-Four.06) though restricted to 2 research. In conclusion, though with limitations, our preliminary meta-analysis means that sufferers with MGUS are at greater danger of fractures regardless of proof for variations in BMD being equivocal. Future longitudinal analysis is required to verify our findings and decide if fracture prevention interventions are warranted in folks with MGUS.
PMID: 28243796 [PubMed – indexed for MEDLINE]