The aim of this study was to determine the collagenase-1 also named metalloproteinase-1 (MMP-1) and its tissue inhibitors, TIMP-1 and TIMP-2 in patients with metabolic syndrome (MetS) and to understand their relationship with the elevated blood pressure.

199 patients with MetS and 150 control subjects were required in the Rabta hospital of Tunis. MMP-1, TIMP-1 and TIMP-2 levels were determined in citrate plasma by ELISA methods.

Levels of MMP-1 decreases significantly in MetS patients compared to control group (p<0.001) in contrast with TIMP-1 which was significantly higher in MetS patients compared to control group (p<0.001). A significant decrease in the levels of MMP-1 and the MMP-1/TIMP-1 ratio was found according to the elevated blood pressure in patients with MetS (p<0.001). Conversely, the TIMP-1 levels increase significantly with high blood pressure (p<0.001). In correlation analysis, negative correlations has been reported between MMP-1 and SBP (Systolic blood pressure) (r=−0.275, p<0.001) and between MMP-1 and DBP (Diastolic blood pressure) (r=−0.298, p<0.001) in patients with MetS. In contrast, the TIMP-1 is positively correlated with the same parameters (r=0.143, p=0.009; r=0.168, p=0.002). The MMP-1/TIMP-1 and MMP-1/TIMP-2 ratios shows the same correlations as those found between MMP-1 and these parameters (r=−0.284, p<0.001; r=− 0.185, p<0.001). According to the linear regression analysis, decreased levels of MMP-1 are independent of the increase in blood pressure.

The decrease of the MMP-1 is associated with a significant increase of its specific inhibitor when blood pressure is high in patients with MetS. These results demonstrate the disruption of the balance between MMPs and their inhibitors and a matrix remodeling that may explain the pathophysiological changes in MetS and the elevated cardiovascular risk.