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[总维生素D、I型前胶原氨基末端前肽和β-交联羧基末端肽在多发性骨髓瘤中的作用]

[Role of Total Vitamin D, Total Procollagen Type I Amino-Terminal Propeptide and β-CrossLaps in Multiple Myeloma].

作者信息

Wang Mei-E, Su Ting, Guo Xi-Zhe, Huang Rong-Fu, Zheng Yu-Yu, Chen Gen-Wang, Fan Chun-Mei

机构信息

Department of clinical laboratory, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.

Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2025 Feb;33(1):163-167. doi: 10.19746/j.cnki.issn.1009-2137.2025.01.023.

Abstract

OBJECTIVE

To analyze the significance of total vitamin D (tVD), total procollagen type I amino-terminal propeptide (tPINP) and β-CrossLaps (β-CTx) in the staging and prognosis of patients with multiple myeloma (MM).

METHODS

A total of 54 patients with newly diagnosed MM admitted to the Second Affiliated Hospital of Fujian Medical University from 2020 to 2022 were selected as the observation group (MM group), and 50 healthy persons who underwent physical examinations in our hospital were selected as the control group. The expression levels of tVD, tPINP and β-CTx in the two groups were detected by chemiluminescence method. The differences in the expression levels of tVD, tPINP and β-CTx among MM patients at different ISS stages were analyzed. The expression levels of tVD, tPINP and β-CTx in MM patients with different levels of hemoglobin (Hb), serum calcium (Ca), creatinine (Crea), albumin (ALB), β-microglobulin (β-MG) and lactate dehydrogenase (LDH) were compared. The correlations between the expression levels of tVD, tPINP, β-CTx and the aforementioned clinical parameters were analyzed, respectively. The relationship between the expression levels of tVD, tPINP, β-CTx and the progression-free survival (PFS) of MM patients was analyzed.

RESULTS

The expression level of tVD in the MM group was significantly lower than that in the control group (21.73±14.45 ng/ml 30.78±9.94 ng/ml, =0.022). The expression level of β-CTx in the MM group was significantly higher than that in the control group (1.43±0.99 ng/ml 0.53±0.29 ng/ml, =0.013). The tVD level in MM patients with ISS stage I-II was significantly higher than that of MM patients with ISS stage III (29.50±14.59 ng/ml 12.62±7.73 ng/ml, =0.028), indicating that the higher the ISS stage, the lower the tVD level. The tPINP and β-CTx levels in MM patients with high Ca levels (>2.65 mmol/L) were significantly higher than those in patients with low Ca levels (≤2.65 mmol/L) ( =0.016, =0.021). The tVD level of MM patients was positively correlated with the ALB level ( =0.570), tPINP was positively correlated with Ca and β-MG levels ( =0.791, =0.673), and β-CTx was positively correlated with tPINP level ( =0.616). The PFS of the low tVD expression group was significantly lower than that of the high tVD expression group ( =0.041).

CONCLUSION

The expression level of tVD is decreased in MM patients, which can be used as an indicator to evaluate the disease stage and prognosis of the patients. The β-CTx expression level is increased in MM patients. tPINP and β-CTx may be correlated with clinical symptoms such as osteolytic lesions and renal function changes in MM patients.

摘要

目的

分析总维生素D(tVD)、总I型前胶原氨基端前肽(tPINP)和β-交联C端肽(β-CTx)在多发性骨髓瘤(MM)患者分期及预后中的意义。

方法

选取2020年至2022年福建医科大学附属第二医院收治的54例新诊断MM患者作为观察组(MM组),选取本院50例健康体检者作为对照组。采用化学发光法检测两组tVD、tPINP和β-CTx的表达水平。分析不同国际分期(ISS)阶段MM患者tVD、tPINP和β-CTx表达水平的差异。比较不同血红蛋白(Hb)、血清钙(Ca)、肌酐(Crea)、白蛋白(ALB)、β-微球蛋白(β-MG)和乳酸脱氢酶(LDH)水平的MM患者tVD、tPINP和β-CTx的表达水平。分别分析tVD、tPINP、β-CTx表达水平与上述临床参数的相关性。分析tVD、tPINP、β-CTx表达水平与MM患者无进展生存期(PFS)的关系。

结果

MM组tVD表达水平显著低于对照组(21.73±14.45 ng/ml对30.78±9.94 ng/ml,P =0.022)。MM组β-CTx表达水平显著高于对照组(1.43±0.99 ng/ml对0.53±0.29 ng/ml,P =0.013)。ISS I-II期MM患者的tVD水平显著高于ISS III期MM患者(29.50±14.59 ng/ml对12.62±7.73 ng/ml,P =0.028),表明ISS分期越高,tVD水平越低。高钙水平(>2.65 mmol/L)的MM患者tPINP和β-CTx水平显著高于低钙水平(≤2.65 mmol/L)的患者(P =0.016,P =0.021)。MM患者的tVD水平与ALB水平呈正相关(P =0.570),tPINP与Ca和β-MG水平呈正相关(P =0.791,P =0.673),β-CTx与tPINP水平呈正相关(P =0.616)。低tVD表达组的PFS显著低于高tVD表达组(P =0.041)。

结论

MM患者tVD表达水平降低,可作为评估患者疾病分期及预后的指标。MM患者β-CTx表达水平升高。tPINP和β-CTx可能与MM患者的溶骨性病变和肾功能改变等临床症状相关。

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