[Association of matrix metalloproteinase 12 with all-cause mortality in Hainan centenarians]

Objective: To understand the association between matrix metalloproteinase 12 (MMP-12) level and all-cause mortality in Hainan centenarians. Methods: Data were derived from the China Hainan Centenarian Cohort Study. Restricted cubic spline (RCS) analyses, Cox proportional-hazards regression and Kaplan-Meier survival curves were used to evaluate the association between MMP-12 level and all-cause mortality. Subgroup analyses and likelihood-ratio tests were performed to explore the interactive effects of age and SBP on this association. Results: A total of 165 centenarians (median age 102.00 years, 83.64% female) were enrolled. The median of follow-up period was 34.10 months, during which 155 deaths occurred (93.94%). MMP-12 level was significantly and positively associated with all-cause mortality (P=0.009, P for nonlinear=0.051). Multivariate analysis indicated that the high-level group (Q₃-Q₄) had a 63% increased risk for death compared with the low-level group (Q₁-Q₂) (HR=1.63, 95%CI: 1.12-2.36, P=0.011). Significant interactions of age and SBP with MMP-12 level were observed (all interaction P<0.05): Younger age and higher SBP had synergistic effect to improve the predictive power of MMP-12 for all-cause mortality risk in centenarians. Conclusion: Elevated MMP-12 level is independently associated with an increased risk for all-cause mortality in Hainan centenarians, which can be modified by age and SBP.