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. 2023 Apr 27:14:1157969.
doi: 10.3389/fendo.2023.1157969. eCollection 2023.

Vitamin D deficiency linked to abnormal bone and lipid metabolism predicts high-risk multiple myeloma with poorer prognosis

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Vitamin D deficiency linked to abnormal bone and lipid metabolism predicts high-risk multiple myeloma with poorer prognosis

Li Bao et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: Vitamin D deficiency is frequent in patients with multiple myeloma (MM), however, its prognostic relevance in MM was rather inconclusive. We first investigated the association of vitamin D deficiency with abnormal bone and lipid metabolism in newly diagnosed multiple myeloma (NDMM), and next assessed the impact of serum ratio of vitamin D to carboxy-terminal telopeptide of type I collagen (β-CTX) on progression-free survival (PFS) and overall free survival (OS) in patients with NDMM.

Methods: The data of 431 consecutive patients with NDMM at Beijing Jishuitan Hospital from September 2013 to December 2022 were collected and retrospectively reviewed through our electronic medical record system. The measurement of 25-hydroxyvitamin D in the blood is an indicator of an individual's overall vitamin D status.

Results: The serum levels of vitamin D were negatively correlated with β-CTX in NDMM patients. Of note, positive correlation between vitamin D and cholesterol levels in the serum was found in this study. The cohort (n = 431) was divided into two groups based on the serum ratio of vitamin D to β-CTX. Compared to the group with a higher vitamin D to β-CTX ratio, the group with a lower vitamin D to β-CTX ratio (n = 257, 60%) exhibited hypocholesterolemia, inferior PFS and OS, along with increased cases of ISS stage-III and R-ISS stage-III, a higher number of plasma cells in the bone marrow, and elevated serum calcium levels. Consistent with this, multivariate analysis confirmed that the vitamin D to β-CTX ratio was an independent unfavorable indicator for survival in NDMM patients.

Conclusion: Our data demonstrated the ratio of vitamin D to β-CTX in the serum is a unique biomarker for NDMM patients to identify the high-risk cases with poor prognosis, which is superior to vitamin D itself for predicting PFS and OS in NDMM. Also, it is worth mentioning that our data on the connection between vitamin D deficiency and hypocholesterolemia might help clarify novel mechanistic aspects of myeloma development.

Keywords: cholesterol; newly diagnosed multiple myeloma; poor survival; ratio of vitamin D to β-CTX; vitamin D.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Level of vitamin D of NDMM patients. (A) The serum level of 25-OH-D3 of all patients; (B) Distribution of patients according to the serum level of 25-OH-D3.
Figure 2
Figure 2
The correlation of vitamin D with cholesterol and β-CTX. (A) Cholesterol; (B) β-CTX.
Figure 3
Figure 3
The markers of bone metabolism affected by vitamin D. (A) tP1NP; (B) β-CTX; (C) OC; (D) PTH. VD, vitamin D; tP1NP, type 1 procollagen amino-terminal propeptide; β-CTX, bone resorption C-terminal telopeptides; OC, osteocalcin; PTH, parathyroid hormone. * represented p-value ≤0.05; *** represented p-value < 0.0001; ns represented p-value >0.05.
Figure 4
Figure 4
Kaplan Meier curves depicting outcomes of patients with values of Vitamin D and VD/β-CTX. The PFS (A) and OS (B) of the two groups divide by vitamin D levels of 10ng/ml. The PFS (C) and OS (D) of the two groups divide by vitamin D levels of 20ng/ml. The PFS (E) and OS (F) of the two groups divide by VD/β-CTX value of 25. VD, vitamin D; PFS, progression-free survival; OS, overall survival; β-CTX, bone resorption C-terminal telopeptides.

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References

    1. Coperchini F, Greco A, Croce L, Petrosino E, Grillini B, Magri F, et al. . Vitamin d reduces thyroid cancer cells migration independently from the modulation of Ccl2 and Cxcl8 chemokines secretion. Front Endocrinol (Lausanne) (2022) 13:876397. doi: 10.3389/fendo.2022.876397 - DOI - PMC - PubMed
    1. Sun HM, Yu Y, Gao XR, Wei YD, Qi CZ, Ma MD, et al. . Potential role of 25(Oh)D insufficiency in the dysfunction of glycolipid metabolism and cognitive impairment in patients with T2dm. Front Endocrinol (Lausanne) (2022) 13:1068199. doi: 10.3389/fendo.2022.1068199 - DOI - PMC - PubMed
    1. Xu D, Gao HJ, Lu CY, Tian HM, Yu XJ. Vitamin d inhibits bone loss in mice with thyrotoxicosis by activating the Opg/Rankl and Wnt/Beta-catenin signaling pathways. Front Endocrinol (Lausanne) (2022) 13:1066089. doi: 10.3389/fendo.2022.1066089 - DOI - PMC - PubMed
    1. van de Peppel J, van Leeuwen JP. Vitamin d and gene networks in human osteoblasts. Front Physiol (2014) 5:137. doi: 10.3389/fphys.2014.00137 - DOI - PMC - PubMed
    1. Cashman KD, van den Heuvel EG, Schoemaker RJ, Preveraud DP, Macdonald HM, Arcot J. 25-hydroxyvitamin d as a biomarker of vitamin d status and its modeling to inform strategies for prevention of vitamin d deficiency within the population. Adv Nutr (2017) 8(6):947–57. doi: 10.3945/an.117.015578 - DOI - PMC - PubMed

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Grants and funding

This work was supported by Beijing JST Research Funding (grant no. XKXX202111).