Department of Hospital Medicine, University of Florida Health, Jacksonville, FL, USA.
Department of Medicine, Emilio Aguinaldo College, Manila, Metro Manila, Philippines.
J Investig Med. 2024 Oct;72(7):674-683. doi: 10.1177/10815589241249998. Epub 2024 Jun 16.
Multiple myeloma (MM), constituting 10% of hematological malignancies, poses significant morbidity and mortality, especially with skeletal involvement. Bisphosphonate use in MM may lead to severe hypocalcemia due to vitamin D deficiency (VDD), exacerbating bone-marrow plasma cell burden. We aimed to assess VDD prevalence and its impact on outcomes in MM patients. A retrospective cross-sectional analysis (2008-2018) of nationwide inpatient data identified adult MM hospitalizations with VDD using ICD-10-CM codes. Univariate and multivariate analyses were conducted to evaluate prevalence, demographics, and outcomes, with significance set at p < 0.05. Among 330,175 MM hospitalizations, 3.48% had VDD. VDD was more prevalent among 50-75 year olds (61.72% vs 59.74%), females (53.36% vs 44.34%), Blacks (23.34% vs 22.94%), Whites (65.84% vs 65.79%), higher income brackets (26.13% vs 23.85%), and those with comorbidities like hypertension (71.12% vs 69.89%), dyslipidemia (42.47% vs 34.98%), obesity (13.63% vs 10.19%), and alcohol abuse (1.61% vs 1.34%). In regression analysis, VDD in MM patients correlated with higher morbidity (adjusted odds ratio (aOR): 1.24, 95% confidence interval (95% CI): 1.14-1.36) and major disability (aOR: 1.26, 95% CI: 1.20-1.30). MM patients with VDD exhibit worse outcomes, underscoring the importance of recognizing and managing VDD promptly. Further prospective studies are needed to validate our findings and explore the impact of vitamin D supplementation on MM patient outcomes.
多发性骨髓瘤(MM)占血液系统恶性肿瘤的 10%,具有显著的发病率和死亡率,尤其是骨骼受累者。MM 患者使用双膦酸盐可能导致维生素 D 缺乏(VDD)引起的严重低钙血症,从而加重骨髓浆细胞负担。我们旨在评估 VDD 的流行率及其对 MM 患者结局的影响。采用国际疾病分类第 10 次修订版临床修正(ICD-10-CM)编码,对 2008 年至 2018 年全国住院患者数据进行回顾性横断面分析,以确定患有 VDD 的成年 MM 住院患者。采用单变量和多变量分析评估流行率、人口统计学特征和结局,p 值<0.05 为差异有统计学意义。在 330175 例 MM 住院患者中,有 3.48%患有 VDD。50-75 岁(61.72% vs 59.74%)、女性(53.36% vs 44.34%)、黑人(23.34% vs 22.94%)、白人(65.84% vs 65.79%)、收入较高(26.13% vs 23.85%)和合并高血压(71.12% vs 69.89%)、血脂异常(42.47% vs 34.98%)、肥胖(13.63% vs 10.19%)和酒精滥用(1.61% vs 1.34%)等并发症的患者中 VDD 更为常见。在回归分析中,MM 患者 VDD 与更高的发病率(调整后的优势比(aOR):1.24,95%置信区间(95%CI):1.14-1.36)和主要残疾(aOR:1.26,95%CI:1.20-1.30)相关。VDD 的 MM 患者预后较差,这突出了及时识别和治疗 VDD 的重要性。需要进一步的前瞻性研究来验证我们的发现,并探讨维生素 D 补充对 MM 患者结局的影响。