Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotic Street, 11000, Belgrade, Serbia.
Acta Neurol Belg. 2020 Oct;120(5):1133-1138. doi: 10.1007/s13760-019-01155-x. Epub 2019 Jun 14.
Polyneuropathy associated with monoclonal gammopathy of undetermined significance (MGUS-PNP) has a chronic and slowly progressive course but can lead to significant disability and reduced quality of life (QoL). The aim of this study was to analyze QoL in MGUS-PNP patients and to determine its predictors. Our study included 51 patients diagnosed with MGUS-PNP (23.5% with IgM, 66.7% IgG or IgA, 7.8% undetermined paraprotein, 2.0% light chains). QoL was assessed using the SF-36 questionnaire. The Medical Research Council Sum Score (MRC-SS), INCAT disability and sensory scores, ataxia score, Krupp's Fatigue Severity Scale and Beck's Depression Inventory were also used. Total SF-36 score was 50.0 ± 21.4 and no difference was observed between IgM and IgG/IgA MGUS-PNP. Physical composite score was worse than mental (44.4 ± 21.4 vs. 54.5 ± 20.9). Following factors showed correlation with SF-36 total score in univariate analysis: INCAT disability score, MRC-SS, INCAT sensory score, level of ataxia, fatigue and depression (p < 0.01). Significant predictors of worse SF-36 total score in our MGUS-PNP patients were depression (β = - 0.46, p < 0.01), fatigue (β = - 0.32, p < 0.01) and INCAT disability score (β = - 0.27, p < 0.01). QoL in MGUS-PNP is equally affected in patients with different types of paraprotein. MGUS-PNP patients with more severe functional disability, fatigue and depression need special attention of clinicians since they could be at higher risk to have worse QoL. This should be taken into account when treating subjects with MGUS-PNP.
多神经病与意义未明的单克隆丙种球蛋白病（MGUS-PNP）相关，具有慢性和缓慢进展的过程，但可导致显著的残疾和生活质量（QoL）降低。本研究的目的是分析 MGUS-PNP 患者的 QoL，并确定其预测因素。我们的研究纳入了 51 名诊断为 MGUS-PNP 的患者（23.5%为 IgM，66.7%为 IgG 或 IgA，7.8%为未确定的副蛋白，2.0%为轻链）。使用 SF-36 问卷评估 QoL。还使用了医学研究委员会总和评分（MRC-SS）、INCAT 残疾和感觉评分、共济失调评分、Krupp 的疲劳严重程度量表和 Beck 的抑郁量表。SF-36 总分 50.0±21.4，IgM 与 IgG/IgA MGUS-PNP 之间无差异。身体综合评分比精神评分差（44.4±21.4 对 54.5±20.9）。单因素分析显示，以下因素与 SF-36 总分相关：INCAT 残疾评分、MRC-SS、INCAT 感觉评分、共济失调程度、疲劳和抑郁（p<0.01）。在我们的 MGUS-PNP 患者中，SF-36 总分的显著预测因素为抑郁（β=-0.46，p<0.01）、疲劳（β=-0.32，p<0.01）和 INCAT 残疾评分（β=-0.27，p<0.01）。不同类型的副蛋白对 MGUS-PNP 患者的 QoL 有同等影响。功能残疾、疲劳和抑郁更为严重的 MGUS-PNP 患者需要临床医生的特别关注，因为他们可能面临更差 QoL 的风险更高。在治疗 MGUS-PNP 患者时应考虑到这一点。
