Associations Between Knee Structural Measures, Circulating Inflammatory Factors and MMP13 in Patients With Knee Osteoarthritis

Osteoarthritis Cartilage. 2018 Aug;26(8):1063-1069. doi: 10.1016/j.joca.2018.05.003. Epub 2018 May 22.


Objective: To investigate cross-sectional associations between serum level of Matrix metalloproteinase (MMP)13 and knee structural measures and circulating inflammatory factors in patients with symptomatic knee osteoarthritis (OA).

Design: A total of 149 subjects with symptomatic knee OA were included. Magnetic resonance imaging was used to measure infrapatellar fat pad (IPFP) volume, IPFP signal intensity alternation, cartilage volume and cartilage defects. Knee radiography was used to assess radiographic OA using the Kellgren-Lawrence (K-L) grading system. Enzyme-linked immunosorbent assay was used to measure the serum levels of inflammatory factors and MMP13.

Results: In multivariable analyses, serum MMP13 was negatively associated with cartilage volume at patellar site (β: -32.94 mm3 per 10 ng/ml, P < 0.05), and positively associated with cartilage defect at medial femoral site (OR: 1.13 per 10 ng/ml, P < 0.05). Also, MMP13 was positively associated with K-L grading and IPFP signal intensity alteration (OR: 1.14 and 1.15 per 10 ng/ml, respectively, both P < 0.05), and negatively associated with IPFP volume (β: -0.34 cm3 per 10 ng/ml, P < 0.05). Furthermore, serum level of adiponectin was negatively associated serum MMP13 quartiles (OR: 0.66 per 10 μg/ml, P < 0.05), and serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-8 and IL-18 were positively associated with serum MMP13 quartiles (ORs: 1.01-1.18 per 10 pg/ml, all P < 0.05).

Conclusions: Serum level of MMP13 was associated with knee structural abnormalities as well as serum inflammatory factors. These suggest that systemic MMP13 may play a role in knee OA, and could be regulated by inflammatory factors.

Keywords: Inflammatory factors; Magnetic resonance imaging; Matrix metalloproteinases 13; Osteoarthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood*
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Interleukin-18 / blood*
  • Interleukin-8 / blood*
  • Knee Joint / diagnostic imaging
  • Knee Joint / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Matrix Metalloproteinase 13 / blood*
  • Middle Aged
  • Osteoarthritis, Knee / blood
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / pathology*
  • Tumor Necrosis Factor-alpha / blood*


  • Adiponectin
  • Interleukin-18
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • MMP13 protein, human
  • Matrix Metalloproteinase 13