What is the risk of osteoporosis in patients with monoclonal gammopathy of undetermined significance (MGUS)?

Updated: Sep 07, 2018
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Using population-based data from Sweden, Kristinsson et al compared the risks of fractures in 5,326 patients with MGUS diagnosed from 1958-2006 with 20,161 matched controls. [25] Patients with MGUS had an increased risk of any fracture at 5 years (hazard ratio [HR] = 1.74) and 10 (HR = 1.61) years. The risk was significantly higher for axial (skull, vertebral/pelvis, and sternum/costae) compared with distal (arm and leg) fractures (P< 0.001).

A French study found that, in addition to low bone density, patients with MGUS who experienced nontraumatic vertebral fractures were more likely to have a lambda light chain isotype. In this prospective study of 201 patients with incidentally discovered MGUS and no known history of osteoporosis, nontraumatic vertebral fracture was discovered in 8.4% of the patients, with equal distribution between men and women. Patients with lambda light chain had an odds ratio of 4.32 (95% confidence interval 1.80–11.16; P=0.002) for fracture, compared with patients with kappa light chain. [26]


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