关键词: β₂-微球蛋白, 血红蛋白, 血钙, 乳酸脱氢酶, 心肾功能共同损伤, 多发性骨髓瘤

Abstract:

Objective To investigate the correlation between concurrent cardiorenal dysfunction in newly diagnosed multiple myeloma（MM） patients and laboratory indicators，and to provide a reference for early identification of high-risk patients and individualized treatment. Methods A total of 235 MM patients from the Department of Hematology of Tangdu Hospital of Air Force Medical University from February 2016 to April 2025 were enrolled. The general data were collected，and laboratory indicators were determined. The patients were classified into normal cardiac and renal function group（91 cases），single organ dysfunction（SOD） group（74 cases） and CRD group（70 cases） according to the levels of N-terminal pro-B-type natriuretic peptide（NT-proBNP） and serum creatinine（SCr）. Spearman correlation analysis was used to evaluate the correlation between laboratory indicators and NT-proBNP，SCr in CRD group. Logistic regression analysis was used to evaluate the influencing factors of CRD occurrence. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of each indicator in diagnosing CRD. Results The hemoglobin（Hb） level in CRD group was lower than those in normal cardiac and renal function group and SOD group（P<0.05），and the levels of Ca，lactate dehydrogenase（LDH），beta₂-microglobulin（β₂-MG），NT-proBNP and SCr were higher than those in normal cardiac and renal function group and SOD group（P<0.05）. There was statistical significance in the types of M protein and the International Staging System（ISS） stage among the 3 groups（P<0.05）. The albumin（Alb） level in CRD group was negatively correlated with NT-proBNP（r=-0.341，P<0.05） and positively correlated with SCr（r=0.346，P<0.05）. LDH was positively correlated with NT-proBNP（r=0.401，P<0.05）. The β₂-MG level was positively correlated with SCr（r=0.382，P<0.05）. The decrease in Hb level，the increase in Ca，LDH and β₂-MG levels were independent risk factors for CRD in MM patients [odds ratios（OR） were 0.973，3.184，1.002 and 1.113，respectively；95% confidence intervals（CI） were 0.953-0.995，1.277-7.934，1.000-1.005 and 1.064-1.163，respectively，P<0.05]. The areas under curves（AUC） for single and combined determinations of Hb，Ca，LDH and β₂-MG in diagnosing CRD in MM patients were 0.747，0.690，0.642，0.925 and 0.929，respectively. Conclusions β₂-MG，Hb，Ca and LDH are independent risk factors for CRD in newly diagnosed MM patients，and their combined determination can improve the sensitivity and negative predictive value for determining CRD，which helps to reduce missed diagnosis and provides a reference for individualized clinical management.

Key words: Beta₂-microglobulin, Hemoglobin, Serum Ca, Lactate dehydrogenase, Concurrent cardiorenal dysfunction, Multiple myeloma