Abstract
BackgroundTendon-ligament injuries (TLIs), including Achilles tendinopathy, cruciate ligament injury, tennis elbow, rotator cuff injury, patellar tendinopathy, and tibial tendinopathy, are common musculoskeletal soft injuries during physical activity. Matrix metalloproteinase-3 (MMP-3) gene polymorphisms have been implicated in the etiology of TLIs in several genetic association studies with inconsistent results. The purpose of this study was to collect and synthesize the current evidences on the association of MMP-3 polymorphisms and TLIs.MethodsThe search was conducted using PubMed, Web of Science, EMBASE, Cochrane Library, CNKI and Wanfang databases, prior to July, 2021. Newcastle Ottawa Scale was used to appraise the study quality. Strengths of association were represented by odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsThirteen studies with 2871 cases and 4497 controls met the eligibility criteria, and each study was in high quality. The overall analyzes suggested rs3025058 was associated with an increased TLIs risk (5A vs. 6A, OR = 1.20, 95% CI 1.03–1.40, P = 0.020). However, the association was not found for rs679620, rs591058, and rs650108 polymorphisms. Subgroup analysis by injury type suggested that rs679620 polymorphism was associated with a reduced risk to Achilles tendon rupture (AA + AG vs. GG, OR = 0.46, 95% CI 0.25–0.87, P = 0.020), and rs3025058 was associated with an elevated risk to anterior cruciate ligament injury (5A5A + 5A6A vs. 6A6A, OR = 1.46, 95% CI 1.03–2.06, P = 0.030). When stratified by ethnicity, the findings indicated that rs3025058 polymorphism was associated with an increased TLIs risk among Caucasians (5A6A vs. 6A6A, OR = 1.55, 95% CI 1.09–2.42, P = 0.020) and Brazilians (5A5A vs. 5A6A + 6A6A, OR = 2.80, 95% CI 1.44–5.45, P = 0.002).ConclusionFindings of this study suggest that rs679620 polymorphism is associated with a reduced Achilles tendon rupture risk, and rs3025058 polymorphism contributes to an increased TLIs risk in Caucasians and Brazilians. However, rs591058 and rs650108 polymorphisms do not show any association with TLIs.
Highlights
Tendon-ligament injuries (TLIs), including Achilles tendinopathy, cruciate ligament injury, tennis elbow, rotator cuff injury, patellar tendinopathy, and tibial tendinopathy, are common musculoskeletal soft injuries during physical activity
Of the remaining 18 items requiring full-text review, another five items were excluded with reasons
Funnel plots did not exhibit obvious asymmetry, suggesting no significant existence of publication bias (Fig. 3). This meta-analysis suggested that rs679620 polymorphism was associated with a reduced Achilles tendon rupture (ARUP) risk, and rs3025058 polymorphism was associated with an increased TLIs risk in the Caucasians and Brazilians
Summary
Tendon-ligament injuries (TLIs), including Achilles tendinopathy, cruciate ligament injury, tennis elbow, rotator cuff injury, patellar tendinopathy, and tibial tendinopathy, are common musculoskeletal soft injuries during physical activity. The purpose of this study was to collect and synthesize the current evidences on the association of MMP-3 polymorphisms and TLIs. Tendons and ligaments within the upper and lower limbs, such as anterior cruciate ligament, rotator cuff tendon, patellar tendon, and Achilles tendon, are common sites of musculoskeletal soft tissue injuries during participating in physical activity [1]. Tendons and ligaments within the upper and lower limbs, such as anterior cruciate ligament, rotator cuff tendon, patellar tendon, and Achilles tendon, are common sites of musculoskeletal soft tissue injuries during participating in physical activity [1] A considerable number of these affected individuals require surgery, imposing a heavy burden on society Both of tendons and ligaments are dense connective tissues which are composed of mesenchymal-derived cells [5]. It is conceivable that tendon-ligament injuries (TLIs) may share similar biological mechanisms
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