Hubungan antara kadar Matriks Metalloproteinase-3 (MMP-3) serum dan gradasi Radiografik pada Osteoartritis Lutut

PURWANTO, Barkah Djaka, dr. Nyoman Kertia, SpPD-KR

2007 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar belakang. Matriks metalloproteinase-3 merupakan enzim yang mampu mendegradasi komponen matriks ekstraseluler dan mengaktivasi proMMP-1, proMMP-7, proMMP-8, proMMP-9 dan proMMP-13. Peningkatan kadar MMP-3 menunjukkan aktivitas destruksi kartilago pada osteoartritis. Pemeriksaan radiologis konvensional masih menjadi standar baku untuk evaluasi kerusakan kartilago artikuler, meskipun mempunyai beberapa keterbatasan. Tujuan penelitian. Mengetahui hubungan antara kadar matriks metalloproteinase-3 (MMP-3) serum dan gradasi radiografik pada osteoartritis lutut. Subyek dan metode penelitian. Penelitian ini dilakukan secara potong lintang pada pasien osteoartritis lutut yang mengunjungi Poliklinik Reumatologi RSUP Dr. Sardjito pada bulan September 2006 sampai Desember 2006. Kadar MMP-3 serum diperiksa dengan instant ELISA. Gradasi radiografik dinilai menurut klasifikasi Kellgren-Lawrence. Hubungan antara kadar MMP-3 serum dan gradasi radiografik dinilai dengan Chi-Square Test atau Fisher’s Exact Test dan multiple logistic regression. Hasil penelitian. Didapatkan 35 subyek penelitian yang dianalisis dengan hasil rerata kadar MMP-3 serum 17,987±20,304 ng/ml, median 10,667 ng/ml dengan rentang 0,334-71,160 ng/ml. Gradasi radiografik didapatkan 20% grade 1; 40% grade 2; 31,4% grade 3 dan 8,6% grade 4. Perbedaan proporsi kadar MMP-3 serum pada gradasi radiografik osteoartritis lutut tidak berbeda bermakna (p= 0,849). Simpulan. Tidak ada hubungan antara kadar MMP-3 serum dan gradasi radiografik pada osteoartritis lutut.

Background. Matrix metalloproteinase-3 is an enzyme wich can degrade many cartilage extracellular and also activate other proMMP-1, proMMP-7, proMMP-8, proMMP-9, and proMMP-13. The elevated levels of serum MMP-3 indicate activity of cartilage destruction in osteoarthritis. Conventional radiological evaluation still remains gold standard. Progression of cartilage damage is best evaluated by plain radiograph. However, radiological evaluation has some limitation. Objective. The purpose of the study was to assess the correlation between serum level of matrix metalloproteinase-3 and radiographic gradation of knee osteoarthritis. Subjects and methods. This is a cross-sectional study in patient with osteoarthritis of the knee recruited from Rheumatology Department, Sardjito General Hospital Yogyakarta on September to December 2006. The serum level of MMP-3 was measured by using an instant ELISA. Knee radiographs were evaluated according to the Kellgren-Lawrence grading scale. Association between serum level of MMP-3 and radiographic gradation was determined by Chi-Square Test or Fisher’s Exact Test and multiple logistic regression. Results. From 35 subjects who fulfilled the criteria, mean of MMP-3 level was 17.987±20,304 ng/ml, median 10.667 ng/ml and range 0.334-71.160 ng/ml. Radiological grading of knee joint were as follow: grade 1, grade 2, grade 3 and grade 4 as 20%, 40%, 31,4% and 8,6% respectively. Proportion of serum level MMP-3 showed no significant differences in radiographic gradation knee osteoarthritis (p=0.849). Conclusion. There was no association between serum level of MMP-3 and radiographic gradation in knee osteoarthritis.

Kata Kunci : Osteoartritis Lutut,MMP 3 dan Gradasi Radiografik,Matrix metalloproteinase-3-radiographic gradation-knee osteoarthritis