Relationship between Serum Matrix Metalloproteinase-8 and Periodontitis: A PRISMA-Compliant Systematic Review and Meta-Analysis

Abstract

Objectives: To determine whether the serum matrix metalloproteinase-8 (MMP-8) level is elevated in periodontitis patients compared with that in periodontally healthy individuals, we conducted a meta-analysis to assess its diagnostic value. This study aims to provide insight into the increased prevalence and severity of systemic diseases in periodontitis patients, as well as the potential of serum MMP-8 in the rapid diagnosis of periodontitis. Methods: A comprehensive search following the PECO criteria of PubMed, Embase and the Cochrane Library from their inception to October 8, 2024, was conducted to retrieve comprehensive relevant articles. The complete selection procedure was meticulously documented with transparency and was registered in PROSPERO CRD42024608648. The methodological qualities of the included articles were evaluated following the Newcastle‒Ottawa Scale (NOS) grading system. The level of serum MMP-8 was converted to a standard (mean ± standard deviation (SD)), and meta-analysis was conducted with Review Manager 5.4 software. Sensitivity analyses were performed with Stata 17.0 software. Results: A total of 12 studies, including 10 case‒control studies and 2 cohort studies, were ultimately included, with a total of 871 participants. The results of the meta-analysis revealed higher serum MMP-8 levels in periodontitis patients than in healthy controls (SMD 0.64, 95% CI 0.27 to 1.01; 12 studies, 871 participants). High heterogeneity (I2 = 86%) indicated variability in outcomes, possibly influenced by regional factors. Duval and Tweedie’s trim and fill procedure was conducted, and no evidence of a small study effect was found. Sensitivity analyses revealed great stability of the data included. Conclusions: Our meta-analysis revealed that the serum MMP-8 level in periodontitis patients was likely greater than that in healthy subjects, but further studies on regional factors are needed to clarify this conclusion considering the degree of heterogeneity.