Assessment of Neutrophil Gelatinase-Associated Lipocalin, Osteocalcin, and Selected Biomarkers in Patients with Multiple Myeloma
Author(s):
Hind Salman Jassim
Date: 09/10/2026
doi: https://doi.org/10.5281/zenodo.8425890
Abstract
Background: Multiple myeloma causes progressive bone destruction and renal impairment, highlighting
the need for reliable biomarkers including NGAL, osteocalcin, and others. Aims of the study: This study
aimed to evaluate neutrophil gelatinase-associated lipocalin (NGAL), osteocalcin, and selected
biochemical biomarkers in patients with multiple myeloma and assess their diagnostic performance and
clinical associations. Methodology: This case–control study was conducted at Baghdad Teaching
Hospital, Iraq, between February and May 2024, including 48 patients with confirmed multiple myeloma
and 52 healthy controls aged 25–90 years. Patients were classified according to renal function status.
Fasting blood samples were collected for biochemical and immunological analyses. Blood urea,
creatinine, and calcium were measured using an automated chemistry analyzer, while serum NGAL,
osteocalcin, fetuin-A, and β2-microglobulin were quantified by sandwich ELISA under standardized
quality-controlled laboratory conditions. Result: Patients with multiple myeloma and healthy controls
were comparable in age and sex (P > 0.05). Serum creatinine, NGAL, β2-microglobulin, and osteocalcin
levels were significantly higher in patients, whereas calcium and Fetuin-A concentrations were
significantly lower (all P < 0.001). No significant sex-related differences were observed among patients.
Correlation analysis revealed predominantly weak-to-moderate biomarker associations. ROC analysis
identified β2-microglobulin (AUC = 0.949) and NGAL (AUC = 0.924) as the most accurate diagnostic
biomarkers, followed by Fetuin-A and osteocalcin. Conclusions: The sensitivity and specificity of NGAL
and β2-microglobulin were excellent for multiple myeloma, and the levels of osteocalcin and Fetuin-A
revealed disease-related bone remodeling. Biomarker assessment could be used to enhance the diagnosis,
evaluation of renal and skeletal involvement, and clinical monitoring of disease course.
Download Full Text