Association of heterogeneity of the thyroid gland with matrix metalloproteinase-3 in rheumatoid arthritis patients with Hashimoto's thyroiditis

Minerva Endocrinol. 2018 Dec;43(4):398-405. doi: 10.23736/S0391-1977.18.02725-6. Epub 2018 Feb 13.


Background: Hashimoto's thyroiditis (HT) is highly prevalent in patients with rheumatoid arthritis (RA). The aim is to determine their relation, focusing on matrix metalloproteinase-3 (MMP-3), a marker predicting joint destruction and RA activity.

Methods: Fifty-three consecutive RA patients were prospectively separated into two groups based on the presence or absence of HT; those with and without TPO-Ab or Tg-Ab (34.0% and 66.0%, respectively). To estimate the extent of inflammation and destruction of the thyroid gland, Heterogeneity Index (HI) was determined ultrasonographically.

Results: While the male/female ratio, TSH and HI were significantly higher in those with HT than in those without (5/13 vs. 7/28, P=0.047, mean±SE; 7.25±0.69 vs.2.52±0.30 mIU/L, P<0.001; 3.8±0.2 vs.3.2±0.2%, P=0.042, respectively), no differences existed in MMP-3. In those with HT, MMP-3 correlated negatively with FT3 (rho=-0.545, P=0.048) and positively with TPO-Ab and HI (rho=0.735, P=0.02; rho=0.769, P=0.01, respectively). Among them, HI was a significant factor associated positively with MMP-3 (r=0.883, F=31.91).

Conclusions: The present study demonstrated significant increases of HI and an association between HI and MMP-3 in RA patients with HT. These findings suggest that the inflammation and destruction of the thyroid gland might be closely related to the current activity and terminal joint destruction of RA.

MeSH terms

  • Arthritis, Rheumatoid / genetics*
  • Arthritis, Rheumatoid / pathology*
  • Female
  • Hashimoto Disease / genetics*
  • Hashimoto Disease / pathology*
  • Humans
  • Joints / pathology
  • Male
  • Matrix Metalloproteinase 3 / genetics*
  • Middle Aged
  • Prospective Studies
  • Thyroid Gland / pathology*


  • MMP3 protein, human
  • Matrix Metalloproteinase 3