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), β2-microglobulin (β2-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 vs 30.78±9.94 ng/ml, P =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 vs 0.53±0.29 ng/ml, P =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 vs 12.62±7.73 ng/ml, P =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) (P =0.016, P =0.021). The tVD level of MM patients was positively correlated with the ALB level (r =0.570), tPINP was positively correlated with Ca and β2-MG levels (r =0.791,r =0.673), and β-CTx was positively correlated with tPINP level (r =0.616). The PFS of the low tVD expression group was significantly lower than that of the high tVD expression group (P =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.
题目: 总维生素D、总I型胶原氨基端延长肽、β-胶原特殊序列在多发性骨髓瘤中的作用.
目的: 分析总维生素D（tVD）、总I型胶原氨基端延长肽（tPINP）、β-胶原特殊序列（β-CTx）在多发性骨髓瘤（MM）分期以及患者预后中的意义。.
方法: 选取2020年至2022年福建医科大学附属第二医院收治的初诊MM患者54例作为观察组（MM组），本院健康体检人员50例作为对照组。用化学发光法检测两组tVD、tPINP、β-CTx的表达水平；分析不同ISS分期的MM患者tVD、tPINP、β-CTx表达水平的差异；比较不同血红蛋白（Hb）、血钙（Ca）、肌酐（Crea）、白蛋白（ALB）、β2-微球蛋白（β2-MG）、乳酸脱氢酶（LDH）水平的MM患者的tVD、tPINP、β-CTx表达水平，并分别将tVD、tPINP、β-CTx表达水平与各临床参数进行相关性分析；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表达水平为21.73±14.45 ng/ml，明显低于对照组的30.78±9.94 ng/ml（P =0.022）；MM组的β-CTx的表达水平为1.43±0.99 ng/ml，明显高于对照组的0.53±0.29 ng/ml（P =0.013）。ISS分期在I-II期的MM患者tVD水平为29.50±14.59 ng/ml，明显高于III期MM患者的12.62±7.73 ng/ml（P =0.028），表明分期越高，tVD水平越低。高Ca水平（>2.65 mmol/L）的MM患者的tPINP、β-CTx均明显高于低Ca水平（≤2.65 mmol/L）患者（P =0.016，P =0.021）。MM患者的tVD水平与ALB水平呈正相关（r =0.570），tPINP水平与Ca、β2-MG水平呈正相关（r =0.791，r =0.673），β-CTx水平与tPINP水平呈正相关（r =0.616）。tVD低表达组的PFS明显低于tVD高表达组（P =0.041）。.
结论: tVD在MM中表达水平降低，其可作为评估疾病分期、预后的指标；β-CTx在MM中表达水平增高；tPINP、β-CTx可能与MM患者的溶骨性表现、肾功能改变等临床症状存在相关性。.
Keywords: total vitamin D; total procollagen type I amino-terminal propeptide; β-CrossLaps; multiple myeloma.