{"title":"多发性骨髓瘤患者维生素 D 缺乏症的患病率、预后和并发症:全国疾病负担。","authors":"Rahul Gujarathi, Manisha Rakesh Lakhanpal, Nikhila Chelikam, Divesh Manjani, Simmy Lahori, Sai Anusha Akella, Prashanth Gumpu Shivashankar, Francis Vino Dominic Savio, Abdirazak Ibrahim Ali, Navyatha Annareddy, Aryak Singh, Lokesh Manjani, Prasanthi Vanga, Avinash Adiga","doi":"10.1177/10815589241249998","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16112,"journal":{"name":"Journal of Investigative Medicine","volume":" ","pages":"674-683"},"PeriodicalIF":2.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence, outcomes, and complications of vitamin D deficiency among patients with multiple myeloma: Nationwide burden of disease.\",\"authors\":\"Rahul Gujarathi, Manisha Rakesh Lakhanpal, Nikhila Chelikam, Divesh Manjani, Simmy Lahori, Sai Anusha Akella, Prashanth Gumpu Shivashankar, Francis Vino Dominic Savio, Abdirazak Ibrahim Ali, Navyatha Annareddy, Aryak Singh, Lokesh Manjani, Prasanthi Vanga, Avinash Adiga\",\"doi\":\"10.1177/10815589241249998\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":16112,\"journal\":{\"name\":\"Journal of Investigative Medicine\",\"volume\":\" \",\"pages\":\"674-683\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Investigative Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10815589241249998\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10815589241249998","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/16 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
多发性骨髓瘤(MM)占血液恶性肿瘤的 10%,发病率和死亡率都很高,尤其是骨骼受累。在多发性骨髓瘤患者中使用双膦酸盐可能会因维生素 D 缺乏(VDD)而导致严重的低钙血症,加重骨髓浆细胞负担。我们旨在评估 VDD 的患病率及其对 MM 患者预后的影响。我们对全国范围内的住院患者数据进行了回顾性横断面分析(2008-2018 年),使用 ICD-10-CM 编码确定了患有 VDD 的成年 MM 住院患者。我们进行了单变量和多变量分析,以评估患病率、人口统计学和预后,显著性设定为 P <0.05。在 330,175 例 MM 住院病例中,3.48% 患有 VDD。在 50-75 岁的人群(61.72% 对 59.74%)、女性(53.36% 对 44.34%)、黑人(23.34% 对 22.94%)、白人(65.84% 对 65.79%)、高收入阶层(26.13% 对 23.85%)中,VDD 的发病率更高。13% vs. 23.85%)、高血压(71.12% vs. 69.89%)、血脂异常(42.47% vs. 34.98%)、肥胖(13.63% vs. 10.19%)和酗酒(1.61% vs. 1.34%)等合并症患者。在回归分析中,MM 患者的 VDD 与较高的发病率(aOR:1.24,95%CI:1.14-1.36)和严重残疾(aOR:1.26,95%CI:1.20-1.30)相关。患有 VDD 的 MM 患者的预后较差,这突出了及时识别和处理 VDD 的重要性。我们需要进一步的前瞻性研究来验证我们的发现,并探讨补充维生素 D 对 MM 患者预后的影响。
Prevalence, outcomes, and complications of vitamin D deficiency among patients with multiple myeloma: Nationwide burden of disease.
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.
期刊介绍:
Journal of Investigative Medicine (JIM) is the official publication of the American Federation for Medical Research. The journal is peer-reviewed and publishes high-quality original articles and reviews in the areas of basic, clinical, and translational medical research.
JIM publishes on all topics and specialty areas that are critical to the conduct of the entire spectrum of biomedical research: from the translation of clinical observations at the bedside, to basic and animal research to clinical research and the implementation of innovative medical care.