Moreover, a ROC curve identified that a serum MMP-9 level >1,011 ng/ml was associated with spontaneous hemorrhage in adult MMD patients with 70.37% sensitivity and 71.88% specificity [area under curve (AUC), 0.73; 95% CI 0.597–0.864; P = 0.003] (Figure 4). This evidence concerns the gene MMP9 and multiminicore myopathy.