Evidence map›Paper›PMID 30488275›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019

Disrupted radial and tibial microarchitecture in patients with monoclonal gammopathy of undetermined significance.

E M Stein, A Dash, M Bucovsky, S Agarwal, J Fu, S Lentzsch, E Shane

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

E M SteinEndocrinology and Metabolic Bone Disease Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. steine@hss.edu.
A DashEndocrinology and Metabolic Bone Disease Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
M BucovskyDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
S AgarwalDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
J FuMultiple Myeloma and Amyloidosis Service, Columbia University College of Physicians and Surgeons, New York, NY, USA.
S LentzschMultiple Myeloma and Amyloidosis Service, Columbia University College of Physicians and Surgeons, New York, NY, USA.
E ShaneDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Funding

Idiopathic Osteoporosis in Premenopausal WomenK24AR052665 · NIAMS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHANE, ELIZABETH J · 2005 to 2014
$1.8M
Chronic Kidney Disease and PTH: Effects on the Postmenopausal SkeletonK23DK084337 · NIDDK · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI STEIN, EMILY MARGARET · 2009 to 2013
$749k
Ultra-high Resolution pQCT as a Biomarker of Bone Strength in Osteoporosis TrialsU01AR055068 · NIAMS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHANE, ELIZABETH J · 2007 to 2010
$644k
Foundation for the National Institutes of Health U01 AR055968NIAMS NIH HHS K24 AR052665NIAMS NIH HHS U01 AR055068NIDDK NIH HHS K23 DK084337
6 · The paper itself

Abstract

Patients with monoclonal gammopathy of undetermined significance (MGUS) had abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness at both the radius and tibia by high-resolution peripheral quantitative CT compared to matched controls. This is the first report demonstrating that patients with MGUS have microarchitectural deficits at multiple skeletal sites.

introductionFracture risk is elevated in patients with monoclonal gammopathy of undetermined significance (MGUS). However, the pathogenesis of bone disease in these patients is poorly understood. Prior work using high-resolution peripheral CT (HRpQCT) demonstrated abnormal microarchitecture at the radius, with predominantly cortical abnormalities. We hypothesized that patients with MGUS have abnormal microarchitecture at both radius and tibia compared to controls, reflecting global skeletal effects of the disease.

methodsThis case-control study enrolled 36 subjects; patients with MGUS (n = 12) were matched 1:2 by age, sex, and race to controls (n = 24). Areal BMD (aBMD) was measured by DXA, vBMD, and microarchitecture by HRpQCT, and whole bone stiffness by finite element analysis. Serum was drawn for markers of bone metabolism and inflammation.

resultsBy DXA, MGUS patients had lower aBMD at the lumbar spine, femoral neck, and 1/3 radius. Markers of bone metabolism and inflammation did not differ. By HRpQCT at the radius, MGUS patients had lower total, trabecular and cortical density, lower trabecular number, and greater trabecular separation and heterogeneity. At the tibia, MGUS patients had lower total and trabecular density, lower trabecular number, greater separation and heterogeneity, and lower whole bone stiffness.

conclusionsPatients with MGUS had lower vBMD, cortical, and trabecular abnormalities at the radius compared to matched controls. At the tibia, trabecular abnormalities predominated. These results suggest that in addition to previously described cortical deficits, deterioration of trabecular bone may contribute to a generalized skeletal fragility in patients with MGUS.

Indexed as

Absorptiometry, PhotonAgedBone DensityCase-Control StudiesFemaleFinite Element AnalysisHumansMaleMiddle AgedMonoclonal Gammopathy of Undetermined SignificanceRadiusTibiaTomography, X-Ray ComputedBone qualityMicroarchitectureMonoclonal gammopathy of undetermined significanceOsteoporosis

Identifiers

PMID30488275
PMCPMC10081445

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.