ArticleBlood advances2026
A nested case-control study of monoclonal gammopathy of undetermined significance in the Multiethnic Cohort study.
Article in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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17 authors.
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Abstract
abstractMonoclonal gammopathy of undetermined significance (MGUS) is a necessary precursor of multiple myeloma (MM). Compared with non-Hispanic White (White) patients, African American individuals experience approximately twofold greater, and Asian American individuals 50% lower, occurrence of MGUS and MM. We examined determinants of MGUS among Japanese American, African American, Latino, Native Hawaiian, and White participants in a case-control study nested in the Multiethnic Cohort (MEC) study. Presumptive cases included MEC participants aged ≥65 years initially screened using the Medicare billing code for paraproteinemia along with those diagnosed with MM or another plasma cell neoplasm at least 1 year after blood draw. Presumptive controls had no Medicare paraproteinemia billing code or MM. Laboratory confirmation resulted in 426 confirmed MGUS cases (370 non-immunoglobulin M [non-IgM] and 56 IgM) and 863 MGUS-free controls. We used multivariable logistic regression to estimate associations with MGUS. The distribution of immunoglobulin isotypes differed by race/ethnicity (P = .005): Japanese American individuals had the lowest (11.0%) and Native Hawaiian individuals the highest (23.5%) proportion of IgA. Each unit increase in body mass index (BMI; kilogram per square meter) was associated with a 6% increase in non-IgM MGUS (95% confidence interval, 3-9) among all racial/ethnic groups combined. BMI was also significantly associated within most racial/ethnic groups, especially among Native Hawaiian individuals (13% increase per BMI unit), with IgA and IgG MGUS, and with high and low risk MGUS. BMI was the main determinant associated with MGUS. Isotype distribution differed between racial/ethnic groups.
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