Park Jooheon, Choi Yong Jun, Lim Ha Jin, Kwon Yong Jun, Shin Myung Geun, Nah Eun-Hee
Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea.
Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.
J Clin Med. 2025 Sep 10;14(18):6381. doi: 10.3390/jcm14186381.
: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established biomarker of cardiac stress and has recently been implicated in hematologic malignancies. However, research on how NT-proBNP changes from monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM), and its association with disease severity and progression, remains limited. This study evaluated whether NT-proBNP levels are associated with disease severity and progression in patients with MGUS and MM. : This retrospective cross-sectional study included 121 patients with MGUS and 472 patients with MM. MGUS risk was stratified based on the presence of three major risk factors, while MM was staged according to the ISS, R-ISS, and R2-ISS systems. Associations between NT-proBNP and clinical or laboratory parameters were evaluated using univariate and multivariate regression. : NT-proBNP levels did not significantly differ between the MGUS and MM groups. In MGUS, NT-proBNP levels were positively associated with β2-microglobulin ( = 0.018) and creatinine ( < 0.001). In MM, NT-proBNP levels increased with advancing disease stage in all staging systems ( < 0.001), but these associations were no longer significant in multivariate models. Instead, β2-microglobulin, LDH, creatinine, and albumin remained independently associated with NT-proBNP levels. : NT-proBNP levels were not associated with MGUS risk factors and showed limited value for risk stratification in MGUS. In MM, NT-proBNP may reflect disease burden but lacks independent value as a marker of disease stage. NT-proBNP may serve as an indicator of overall disease burden, but has limited value as an independent biomarker for disease severity in MM.
N 端前 B 型利钠肽（NT-proBNP）是一种公认的心脏应激生物标志物，最近被认为与血液系统恶性肿瘤有关。然而，关于 NT-proBNP 如何从意义未明的单克隆丙种球蛋白病（MGUS）转变为多发性骨髓瘤（MM），以及其与疾病严重程度和进展的关系的研究仍然有限。本研究评估了 NT-proBNP 水平是否与 MGUS 和 MM 患者的疾病严重程度和进展相关。：这项回顾性横断面研究纳入了 121 例 MGUS 患者和 472 例 MM 患者。MGUS 风险根据三个主要风险因素的存在进行分层，而 MM 则根据国际分期系统（ISS）、修订国际分期系统（R-ISS）和 R2-ISS 系统进行分期。使用单变量和多变量回归评估 NT-proBNP 与临床或实验室参数之间的关联。：MGUS 组和 MM 组的 NT-proBNP 水平无显著差异。在 MGUS 中，NT-proBNP 水平与β2-微球蛋白（P = 0.018）和肌酐（P < 0.001）呈正相关。在 MM 中，NT-proBNP 水平在所有分期系统中均随疾病分期进展而升高（P < 0.001），但在多变量模型中这些关联不再显著。相反，β2-微球蛋白、乳酸脱氢酶、肌酐和白蛋白仍与 NT-proBNP 水平独立相关。：NT-proBNP 水平与 MGUS 风险因素无关，在 MGUS 风险分层中价值有限。在 MM 中，NT-proBNP 可能反映疾病负担，但作为疾病分期标志物缺乏独立价值。NT-proBNP 可作为总体疾病负担的指标，但作为 MM 疾病严重程度的独立生物标志物价值有限。
