Expressions of insulin-like growth factor-1, interleukin-1β, and matrix metalloproteinase-13 in patients with knee osteoarthritis and their associations with the severity

Abstract Background A key factor in the pathogenesis of osteoarthritis is an imbalance in cytokines, favoring proinflammatory activity. This study aimed to explore the expressions of insulin-like growth factor-1 (IGF-1), interleukin-1β (IL-β) and matrix metalloproteinase-13 (MMP-13) in patients with knee osteoarthritis (KOA), as well as their associations with the severity. Methods Subjects (166 in total) were recruited from KOA patients treated between January 2021 and June 2023. Their clinical data were collected, disease severity was assessed by Kellgren-Lawrence (K-L) grades, and venous blood was drawn to measure the serum levels of IGF-1, MMP-13, and IL-1β. Factors affecting the severity of KOA were analyzed by multivariate logistic regression model incorporating the aforementioned information. Results There were more cases of disease course >1 year, body mass index (BMI) >25 kg/m2, heavy physical labor, and osteoporosis in the severe group (P<0.05). Multivariate logistic regression analysis revealed that disease course >1 year, BMI >25 kg/m2, heavy physical labor, osteoporosis, lowly expressed MMP-13, and lowly expressed IL-1β were risk factors for the severity of KOA [odds ratio (OR) >1, P<0.05], while highly expressed IGF-1 was a protective factor (OR<1, P<0.05). The areas under the receiver operating characteristic (ROC) curves (95% confidence interval) of IGF-1, MMP-13, and IL-1β levels and their combination for assessing the severity of KOA were 0.883 (0.823-0.942), 0.880 (0.827-0.934), 0.895 (0.847-0.943), and 0.923 (0.877-0.968), respectively. Conclusions IGF-1 is lowly expressed, whereas MMP-13 and IL-1β are highly expressed. The combined application of the three indicators has the highest value for assessing the severity of KOA.