This study was designed to explore the value of markers of bone turnover, macrophage inflammatory protein-1alpha (MIP-1alpha), and
osteopontin (OPN) in the diagnosis of myeloma
bone disease. Twenty-five patients with newly diagnosed and untreated
multiple myeloma (MM), and 22 age-, sex-, and bone mineral density-matched control subjects were enrolled. Levels of
MIP-1alpha, OPN, carboxy-terminal telopeptide of Type-1
collagen (
C-telopeptide or Ctx),
deoxypyridinoline (DPD), Type-1
collagen propeptide (T1Pro), and bone-specific
alkaline phosphatase (BALP) were assessed in both groups. Twenty-two of the patients had bone involvement documented by skeletal surveys and lumbar spinal magnetic resonance imaging. Levels of serum Ctx, OPN,
MIP-1alpha, and urine DPD were significantly higher in MM patients with
bone disease than in controls (P<0.01). Serum Ctx levels were elevated in 90.9% of patients with MM and 40.9% of controls (P<0.001). Urine DPD levels were elevated in 90.4% of the patients and 31.8% of the controls (P<0.001). The serum OPN and
MIP-1alpha levels of the patients were significantly correlated with beta2-microglobulin and
lactate dehydrogenase levels (P<0.05). Our study indicates that Ctx and DPD are sensitive markers of
bone disease in MM, and higher than normal values suggest presence of
bone disease rather than benign
osteoporosis in MM. The utility of OPN and
MIP-1alpha needs to be further investigated.