Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2022 Dec 5;31(12):2192-2198. doi: 10.1158/1055-9965.EPI-22-0525.
Both multiple myeloma and its precursor, monoclonal gammopathy of undetermined significance (MGUS), occur twice as often within Black compared with White populations, suggesting that racial disparities lie within the development of MGUS. Nonetheless, MGUS has been studied mainly in White cohorts; the study that first described the natural history of MGUS was conducted in 97.3% White Olmsted County, Minnesota.
We determined the prevalence of MGUS among 386 Black South African (SA) men >30 years at Chris Hani Baragwanath Hospital in Johannesburg. We conducted serum protein electrophoresis and free light chain quantification to define MGUS by the same criteria as the Olmsted County studies. We also investigated the association between MGUS and various clinical factors, including human immunodeficiency virus (HIV) infection and smoking.
We found the prevalence of MGUS to be 8.03% [95% confidence interval (CI), 5.32-10.74], nearly 1.6-fold higher than in the White Olmsted County male population. In a univariable logistic regression model, MGUS was associated with HIV status (OR, 2.39; 95% CI, 0.95-5.49), but in an adjusted model that included body mass index and cigarette use, the association was not statistically significant. Those who were current (vs. never) cigarette smokers were more likely to have MGUS in both univariable (OR, 5.60; 95% CI, 2.16-17.42) and multivariable models (OR, 4.49; 95% CI, 1.63-14.56).
The prevalence of MGUS in Black SA men is substantially higher than in White populations and may be associated with HIV status and cigarette use.
Racial disparities in MGUS exist and may be associated with potentially modifiable risk factors.
多发性骨髓瘤及其前体——意义未明的单克隆丙种球蛋白血症（MGUS），在黑人群体中的发病率是白人群体的两倍，这表明种族差异存在于 MGUS 的发展过程中。尽管如此，MGUS 主要在白人群体中进行研究；首次描述 MGUS 自然史的研究是在明尼苏达州奥姆斯特德县 97.3%的白人中进行的。
我们在约翰内斯堡克里斯·哈尼·巴哈加万萨医院（Chris Hani Baragwanath Hospital），确定了 386 名 30 岁以上的南非黑人（SA）男性中 MGUS 的患病率。我们通过与奥姆斯特德县研究相同的标准进行血清蛋白电泳和游离轻链定量，以定义 MGUS。我们还研究了 MGUS 与各种临床因素（包括人类免疫缺陷病毒（HIV）感染和吸烟）之间的关系。
我们发现 MGUS 的患病率为 8.03%[95%置信区间（CI），5.32-10.74]，几乎是白人奥姆斯特德县男性人口的 1.6 倍。在单变量逻辑回归模型中，MGUS 与 HIV 状态相关（比值比，2.39；95%CI，0.95-5.49），但在包括体重指数和吸烟的调整模型中，这种关联没有统计学意义。在单变量（比值比，5.60；95%CI，2.16-17.42）和多变量模型（比值比，4.49；95%CI，1.63-14.56）中，当前（vs. 从未）吸烟者更有可能患有 MGUS。
南非黑人男性中 MGUS 的患病率明显高于白人人群，并且可能与 HIV 状态和吸烟有关。
MGUS 存在种族差异，并且可能与潜在可改变的危险因素有关。
