Independent Risk Factors Influencing the Occurrence of Osteoporotic Fracture in Patients with Multiple Myeloma and Construction of A Risk Prediction Model
MA Jianmiao
LIU Jing
XU Jielin
BAI Ningjuan
WANG Ning
HAN Lei
Abstract：Objective To analyze the risk factors for osteoporotic fracture in patients with multiple myeloma(MM)and construct a risk prediction model.Methods A total of 126 MM patients admitted to the First Affiliated Hospital of Air Force Military Medical University from January 2020 to December 2023 were selected.According to the occurrence of osteoporotic fracture,they were divided into a fracture group(44 cases)and a non-fracture group(82 cases).General data and laboratory indicators were compared between the two groups.Multivariate Logistic regression analysis was used to identify influencing factors for osteoporotic fracture in MM patients.A prediction model was constructed based on the influencing factors,and a ROC curve was plotted to evaluate the predictive value of the model for osteoporotic fracture in MM patients.Results Age≥60 years,bone marrow plasma cell percentage,and levels of β-carboxy-terminal cross-linking telopeptide of type Ⅰ collagen(β-CTx)and β2-microglobulin(β2-MG)were higher in the fracture group than in the non-fracture group,while the level of mid-region osteocalcin(OCN-Mid)was lower(P<0.05).Multivariate Logistic regression analysis showed that age≥60 years,increased bone marrow plasma cell percentage,elevated β-CTx,decreased OCN-Mid,and elevated β2-MG were independent risk factors for osteoporotic fracture in MM patients(OR=1.369,95％CI:1.123-1.669,P=0.002;OR=1.461,95％CI:1.173-1.819,P=0.001;OR=1.478,95％CI:1.199-1.823,P<0.01;OR=1.510,95％CI:1.198-1.903,P=0.001;OR=1.536,95％CI:1.231-1.916,P<0.01).A prediction model was constructed based on the above factors.The Hosmer-Lemeshow test indicated good model fit.ROC curve analysis showed that the AUC of the model for predicting osteoporotic fracture in MM patients was 0.922,with a sensitivity of 88.64％and a specificity of 89.02％.Conclusion Age,bone marrow plasma cell percentage,and levels of β-CTx,OCN-Mid,and β2-MG are closely associated with the occurrence of osteoporotic fracture in MM patients.The prediction model constructed based on these factors has good predictive value and can provide a reference for clinical practice.
Keywords：multiple myelomaosteoporotic fracturerisk factorsrisk prediction model
Publication Date：2025-10-20
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：5( 97-101 )