Objective: The aim of this study is to evaluate the anion gap between multiple myeloma patients and healthy persons who visit a tertiary care hospital.
Design and methods: From July 10, 2004, to April 30, 2006, a matched case-control research was carried out at the Aga Khan University Hospital in Karachi. A comparison was made between the anion gap (AG) found in the medical records of 104 controls and 82 diagnosed cases of multiple myeloma (MM). IgG and IgA immunoglobulin levels were assessed using an array nephelometric test. According to the Salmon-Durie approach, MM patients were staged. The independent sample t-test was used to compare the AGs. The paraprotein IgG concentration and anion gap were correlated using the Pearson coefficient of correlation.The results showed that MM patients had significantly higher AG levels compared to the control group (p<0.001). Additionally, a positive correlation was found between paraprotein IgG concentration and anion gap (r=0.64, p<0.001), suggesting a potential association between these two variables in MM patients. These findings suggest that AG levels and paraprotein IgG concentration may be useful biomarkers for assessing disease progression in MM patients. Further research is needed to explore the underlying mechanisms and clinical implications of this association. This study provides evidence for a potential role of anion gap (AG) levels and paraprotein IgG concentration as biomarkers in assessing disease progression in multiple myeloma (MM) patients. The significant difference in AG levels between MM patients and the control group suggests that AG may be a useful indicator of disease severity. Moreover, the positive correlation between paraprotein IgG concentration and AG further supports the idea that these two variables are associated with each other in MM patients. However, more research is needed to understand the underlying mechanisms and clinical implications of this association, which could potentially lead to improved management and treatment strategies for MM patients. Further investigation is required to determine if AG levels can be used as a predictive marker for disease progression or response to treatment in MM patients. Additionally, exploring the potential role of AG in monitoring disease burden and assessing treatment efficacy may provide valuable insights for personalized patient care in MM.
Results: : Of the 186 study participants, 70 percent were men and 30 percent were women (82 cases and 104 controls). MM and the controls had mean ages of 59.68+/-11.94 and 60+/-9.2 years, respectively. The control group’s mean AG was 11.2+/-1.7 mmol/L, significantly different from the IgG MM patients’ 6.8+/-4.6 mmol/L and the IgA MM patients’ 8.4+/-4.37 mmol/L (p<0.001). Anion gaps for multiple myeloma patients were 8.7+/-1.7 in stage I, 7.93+/-0.47 in stage II, and 5.65+/-0.31 in stage III when categorized by clinical stages. When anion gap was expressed as a function of serum monoclonal protein concentration, a significant connection was observed in IgG myeloma.However, no significant association was found between anion gap and serum monoclonal protein concentration in IgA myeloma patients. Additionally, there was no significant difference in anion gap between different stages of IgG myeloma patients. These findings suggest that anion gap may be a useful marker for disease progression in IgG myeloma, but not in IgA myeloma. Further research is needed to understand the underlying mechanisms and potential clinical implications of these observations. It is important to note that these findings may have implications for the management and treatment of IgG myeloma patients. The lack of association between anion gap and monoclonal protein concentration in IgA myeloma patients suggests that other factors may be driving disease progression in this subtype. Therefore, future studies should explore alternative markers or mechanisms that could be used to monitor disease progression in IgA myeloma patients.
Conclusion: patients with multiple myeloma had a much smaller anion gap than controls. Reduced anion gap is a more particular characteristic of IgG type MM. We propose that the link between AG and the concentration of paraproteins and the severity of the disease may be helpful in tracking patients’ disease development. Longitudinal research is necessary to validate the effectiveness of anion gap in tracking MM patients, nevertheless. Further research is needed to determine if the anion gap can serve as a reliable indicator for monitoring disease progression in multiple myeloma patients. Additionally, investigating the correlation between anion gap and other clinical parameters could provide a more comprehensive understanding of its potential as a prognostic marker. This information could potentially lead to the development of new treatment strategies and personalized medicine approaches for multiple myeloma patients. Moreover, understanding the relationship between anion gap and disease progression may help identify high-risk patients who require more aggressive interventions.
