Landgren Ola, Katzmann Jerry A, Hsing Ann W, Pfeiffer Ruth M, Kyle Robert A, Yeboah Edward D, Biritwum Richard B, Tettey Yao, Adjei Andrew A, Larson Dirk R, Dispenzieri Angela, Melton L Joseph, Goldin Lynn R, McMaster Mary L, Caporaso Neil E, Rajkumar S Vincent
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, Bldg. EPS/Room 7110, Bethesda, MD 20892-7236, USA.
Mayo Clin Proc. 2007 Dec;82(12):1468-73. doi: 10.1016/S0025-6196(11)61089-6.
To determine the prevalence of monoclonal gammopathy of undetermined significance (MGUS), a precursor of multiple myeloma (MM), in Ghanaian men vs white men and to test for evidence to support an underlying race-related predisposition of the 2-fold higher prevalence of MGUS in African Americans vs whites.
Between September 1, 2004, and September 30, 2006, 917 men (50-74 years) underwent in-person interviews and physical examinations. Serum samples from all participants were analyzed by electrophoresis performed on agarose gel; any serum sample with a discrete or localized band was subjected to immunofixation. Age-adjusted and standardized (to the 2000 world population) prevalence estimates of MGUS and 95% confidence intervals (CIs) were computed in the Ghanaian men and compared with MGUS prevalence in 7996 white men from Minnesota. Associations between selected characteristics and MGUS prevalence were assessed by the Fisher exact test and logistic regression models.
Of the 917 study participants, 54 were found to have MGUS, yielding an age-adjusted prevalence of 5.84 (95% CI, 4.27-7.40) per 100 persons. No significant variation was found by age group, ethnicity, education status, or prior infectious diseases. The concentration of monoclonal immunoglobulin was undetectable in 41 (76%) of the 54 MGUS cases, less than 1 g/dL in 10 patients (19%), and 1 g/dL or more in only 3 patients (6%). Compared with white men, the age-adjusted prevalence of MGUS was 1.97-fold (95% CI, 1.94-2.00) higher in Ghanaian men.
The prevalence of MGUS in Ghanaian men was twice that in white men, supporting the hypothesis that race-related genetic susceptibility could explain the higher rates of MGUS in black populations. An improved understanding of MGUS and MM pathophysiology would facilitate the development of strategies to prevent progression of MGUS to MM.
确定意义未明的单克隆丙种球蛋白病（MGUS）（多发性骨髓瘤（MM）的前驱疾病）在加纳男性与白人男性中的患病率，并检验是否有证据支持非裔美国人中MGUS患病率比白人高两倍这一潜在的种族相关易感性。
在2004年9月1日至2006年9月30日期间，917名年龄在50至74岁之间的男性接受了面对面访谈和体格检查。对所有参与者的血清样本进行琼脂糖凝胶电泳分析；任何出现离散或局限性条带的血清样本均进行免疫固定。计算加纳男性中MGUS的年龄调整患病率和标准化（以2000年世界人口为标准）患病率估计值及95%置信区间（CI），并与来自明尼苏达州的7996名白人男性中的MGUS患病率进行比较。通过Fisher精确检验和逻辑回归模型评估选定特征与MGUS患病率之间的关联。
在917名研究参与者中，发现54人患有MGUS，年龄调整患病率为每100人中有5.84例（95%CI，4.27 - 7.40）。在年龄组、种族、教育程度或既往传染病方面未发现显著差异。54例MGUS病例中有41例（76%）未检测到单克隆免疫球蛋白浓度，10例患者（19%）低于1g/dL，仅3例患者（6%）为1g/dL或更高。与白人男性相比，加纳男性中MGUS的年龄调整患病率高1.97倍（95%CI，1.94 - 2.00）。
加纳男性中MGUS的患病率是白人男性的两倍，支持了种族相关遗传易感性可解释黑人中MGUS较高发病率这一假设。更好地理解MGUS和MM的病理生理学将有助于制定预防MGUS进展为MM的策略。
