Do MGUS patients have a higher risk of fracture than people without MGUS? Why?

Do MGUS patients have a higher risk of fracture than people without MGUS? MGUS patients have a higher risk of fracture than patients who are basically matched for age, sex, and BMI. So if you basically take a 70-year-old patient and she has MGUS, and if you have her next-door neighbor who is the same age, same sex, also a woman, and has the same BMI, so basically the same weight, that patient with MGUS would have a much higher risk for having a fracture. Instead of a higher risk for spine fractures, basically axial fractures, anywhere sort of along your central skeleton, or even on your long bones, like your hips and things like that. So the risk, it varies at different sites, but the highest risk would be at the vertebrae. You have a risk of having a fracture of your back about six to seven fold higher if you have MGUS than if you don't have MGUS than you're otherwise matched for everything else. We think the reason that that is is because even in patients who don't have multiple myeloma, they have these clonal cells. They haven't caused a problem yet within the bone. They haven't caused any of the problems that we would say have myeloma. They don't have the CRAB criteria, basically. Their calcium levels aren't high. They don't have renal failure. They don't have anemia. They don't have any bone lesions. But these cells still secrete low levels of what we call cytokines, which are factors that get released by the myeloma cells that, like as happens in multiple myeloma, we think these cytokines still affect the cells called the osteoclasts that scoop out the bone and the osteoblasts that normally put back the bone. And the level is much lower than the cytokines, and they are in multiple myeloma, but they're still going on. And they get released by these cells. They probably circulate around the blood, and then they can affect these bone cells anywhere in the body. As a result, these patients tend to lose bone. And when you lose bone, then your bone becomes less strong, and you have a higher risk for having a fracture.