In rabbit, the glycation-induced collagen cross-linking is directly associated with an increased matrix stiffness and other mechanical attributes of the tendon.[44] In addition,high glucose concentration up-regulates the expression of metalloproteinasesMMP-9 and MMP-13 in tendon cells that exert a detrimental effect on tendon structure.[45]From the other side, hyperglycemia produces a reduction in proteoglycans levels related to decreased synthesis or sulfation of glycosaminoglycans, which may contribute to tendon pathology.[46]. The gene discussed is MMP13; the disease is Hyperglycemia.