Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults

The offsetting relationship between hand grip strength and hypertension: A cross-sectional study from physically disabled over 50 years old in China

OBJECTIVES

To explore the relationship between hand grip strength (HGS) and blood pressure in physically disabled individuals over 50 years old.

METHODS

The research adopts a cross-sectional survey, and the data comes from the "2022-2023 Physical Health Monitoring and Scientific and Technological Services for Physical Disabilities" jointly carried out by Beijing Sport University and China Disabled Sports Management Center. Select physically disabled individuals over 50 years old and collect physical fitness measurement data. HGS was measured and adjusted based on body weight and waist circumference, with standard normal conversion. The relationship between HGS and blood pressure was analyzed using multiple linear regression, and further logistic regression was used to analyze the relationship between standard HGS and the risk of abnormal blood pressure.

RESULTS

695 disabled individuals participated in the experiment, including 402 males (57.84%) and 293 females (42.16%). Multiple linear regression analysis found that for each standard deviation increase in the standardized Z-value of relative HGS, the systolic and diastolic blood pressure of male individuals decreased by 2.391 mmHg (P = 0.008) and 1.229 mmHg (P = 0.025); decreased by 2.336 mmHg (P = 0.026) and 1.585 mmHg (P = 0.008), respectively, for female. The increase in HGS reduced the risk of hypertension in physical disabilities in males [OR = 0.820 95%CIs (0.670, 0.952)] (P = 0.003) and females [OR = 0.735 95%CIs (0.472, 0.986)] (P = 0.007).

CONCLUSION

The HGS of middle-aged and elderly physically disabled individuals negatively correlates with blood pressure, indicating the importance of increasing muscle strength (HGS) in preventing blood pressure.

Sustainability of exercise-induced benefits on circulating MicroRNAs and physical fitness in community-dwelling older adults: a randomized controlled trial with follow up

BACKGROUND

Circulating miRNAs (c-miR) have been shown to be potential biomarkers in sarcopenia, but the miRNAs response to aerobic exercise in older people remains inconclusive. We sought to examine the exercise benefits on physical fitness and miRNAs, and to explore the mediating effect of miRNAs on training-induced fitness changes.

METHODS

This controlled trial recruited 58 community-dwelling older adults and randomized them into exercise group (EX) and control group (CON). EX received 8-week supervised moderate intensity cycling training 3x/week. C-miR expression (c-miR-21, c-miR-126, c-miR-146a, c-miR-222), physical fitness (body composition, cardiorespiratory fitness, muscular fitness) and physical activity level (PAL, measured as in daily step counts) were evaluated at baseline, post-training, and post-16-week follow-up. The mediating effect of miRNA expression onto exercise-induced physical fitness change was determined by causal mediation analysis (CMA).

RESULTS

Exercise significantly improved body fat and cardiorespiratory fitness in older people while maintaining muscle mass and strength, and augmented expression of c-miR-126, c-miR-146a, and c-miR-222 for up to 16 weeks post-training. Notably, older people in EX had substantially higher daily step counts than CON throughout the study even after the active training period. However, CMA revealed no significant indirect effect but a potential mediating effect of c-miR-21, but not the rest, onto the body composition, cardiorespiratory fitness, and lower limb strength.

CONCLUSION

An eight-week supervised MICT program promoted a higher level of physical activity up to 16 weeks post-training, which induces better cardiorespiratory fitness and resists decline in muscular measures. C-miRNA, especially c-miR-21, potentially mediates the training effect upon fitness.

Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study

Background: Sarcopenia is defined as the loss of muscle mass and strength and low physical performance, and it is closely related to the risk of cardiovascular disease and mortality. Pulse pressure (PP) is a biomarker of arterial stiffness and compliance. Elevated PP levels increase the risk of cardiovascular diseases and all-cause mortality. Nevertheless, the association between PP and sarcopenia has not yet been clearly established. Methods: Participant data were extracted from the Korea National Health and Nutrition Examination Survey conducted from 2014 to 2020. The study population was classified into three groups (PP < 40 mmHg, 40 mmHg ≤ PP < 60 mmHg, and PP ≥ 60 mmHg). PP was calculated by deducting the diastolic blood pressure from the systolic blood pressure. For handgrip strength, the maximum value measured with a grip dynamometer was adopted (weak handgrip strength: <28 kg for men, <18 kg for woman; normal handgrip strength: ≥28 kg for men, ≥18 kg for women). To determine the relationship between PP and the prevalence of weak handgrip strength, multiple logistic regression analysis was performed after adjusting for possible confounding factors. Results: The higher PP group had a higher age, body mass index; systolic blood pressure, prevalence of hypertension, diabetes, hyperlipidemia, and metabolic syndrome, and maximum handgrip strength. In all models, the prevalence of weak handgrip strength was significantly higher in the group with PP ≥ 60 mmHg compared to the control group (PP < 40 mmHg). Conclusions: Elevated PP was significantly associated with a higher prevalence of weak muscle strength. Thus, PP monitoring may be used to identify individuals at risk of sarcopenia and is helpful in improving health outcomes.

Association of physiological factors with grip and leg extension strength: tohoku medical megabank community-based cohort study

BACKGROUND

Upper and lower extremity muscle strength can be used to predict health outcomes. However, the difference between the relation of upper extremity muscle and of lower extremity muscle with physiological factors is unclear. This study aimed to evaluate the association between physiological data and muscle strength, measured using grip and leg extension strength, among Japanese adults.

METHODS

We conducted a cross-sectional study of 2,861 men and 6,717 women aged ≥ 20 years living in Miyagi Prefecture, Japan. Grip strength was measured using a dynamometer. Leg extension strength was measured using a hydraulic isokinetic leg press machine. Anthropometry and physiological data, including blood pressure, calcaneal ultrasound bone status, pulmonary function, carotid echography, and blood information, were assessed. We used a general linear model adjusted for age, body composition, and smoking status to evaluate the association between muscle strength and physiological factors.

RESULTS

Grip and leg extension strength were positively associated with bone area ratio, vital capacity, forced vital capacity, forced expiratory volume in one second, and estimated glomerular filtration rate, and negatively associated with waist circumference and percentage body fat mass in both the sexes. Diastolic blood pressure was positively associated with grip strength in both the sexes and leg extension strength in men, but not women. High-density lipoprotein cholesterol and red blood cell counts were positively associated with grip and leg extension strength in women, but not men. In both the sexes, pulse rate, total cholesterol, and uric acid were consistently associated with only leg extension strength, but not grip strength. In women, glycated hemoglobin demonstrated negative and positive associations with grip and leg extension strength, respectively.

CONCLUSIONS

Grip and leg extension strength demonstrated similar associations with anthropometry, pulmonary function, and estimated glomerular filtration rate, but the associations with the other factors were not always consistent.

Grip strength positively correlates with blood pressure in individuals with abnormal adiposity

Although strong positive correlations exist between grip strength and cardiovascular health, the association between grip strength and blood pressure (BP) is less clear. In this regard, a more precise relationship between grip strength and BP may be revealed by considering adiposity. We examined the association between grip strength and BP in 9424 individuals aged 18-92 years, while controlling for or stratifying by body mass index (BMI) or body fat (BF)%. Grip strength, BP and BF% were determined using dynamometry, sphygmomanometry and dual-energy x-ray absorptiometry. Overall, those with elevated BP had greater grip strength than those with normal BP (39.17 kg vs 38.38 kg, p < 0.001); however, following stratification this was only observed in overweight or obese individuals (42.08 kg vs 41.10 kg, p = 0.003 and 41.34 kg vs 40.03 kg, p = 0.033), and those within the highest BF% tertile (37.95 kg vs 36.52 kg, p < 0.001). Overall, higher grip strength was associated with an increased odds for elevated BP (OR = 1.014, 95% CI = 1.004-1.024, p = 0.004); however, after stratification the increased odds was only observed in overweight or obese individuals (OR = 1.025, 95% CI = 1.010-1.039, p < 0.001 and OR = 1.018, 95% CI = 1.004-1.031, p = 0.010), and those within the highest BF% tertile (OR = 1.036, 95% CI = 1.022-1.051, p < 0.001). Individuals with low grip strength and high BF% had lower odds for elevated BP (OR = 0.514, 95% CI = 0.341-0.775, p = 0.002), whereas those with low grip strength and low BF% had higher odds for elevated BP (OR = 2.162, 95% CI = 1.026-4.555, p = 0.043). Our findings show that higher grip strength is related to higher BP in overweight or obese individuals, or those with a high BF%. Having a BMI < 25 kg/m2 or lower BF% may neutralise this association.

Hand grip strength as a proposed new vital sign of health: a narrative review of evidences

Hand grip strength (HGS) serves as a fundamental metric in assessing muscle function and overall physical capability and is particularly relevant to the ageing population. HGS holds an important connection to the concept of sarcopenia, which encompasses the age-related decline in muscle mass, strength, and function. It has also been reported to indicate the health of an individual. We reviewed the interplay between HGS and various health parameters, including morbidity and mortality, by carrying out a literature search on PubMed, Scopus and Google Scholar between 10 and 30 August 2023, to identify the relevant papers on the relationship between health and HGS. We used several keywords like 'hand grip strength', 'muscle strength, 'sarcopenia', 'osteosarcopenia', 'health biomarker', 'osteoporosis', and 'frailty', to derive the appropriate literature for this review. This review has shown that the HGS can be measured reliably with a hand-held dynamometer. The cut-off values are different in various populations. It is lower in Asians, women, less educated and privileged, and those involved in sedentary work. Several diseases have shown a correlation with low HGS, e.g., Type 2 diabetes, cardiovascular disease, stroke, chronic kidney and liver disease, some cancers, sarcopenia and fragility fractures. The low HSG is also associated with increased hospitalization, nutritional status, overall mortality and quality of life. We believe that there is adequate evidence to show that HGS stands as an important biomarker of health. Its utility extends to the identification of diverse health issues and its potential as a new vital sign throughout the lifespan.

Association of Anthropometric Adiposity Indices and Hand Grip Strength among Male Industrial Workers in Chennai, Tamil Nadu, India: A Cross-Sectional Study

Background

Hand Grip Strength (HGS), a basic, non-invasive measure of musculoskeletal function is found to be a risk marker for cardiovascular diseases, respiratory diseases, diabetes, metabolic syndrome, and cancer. Considering the importance and paucity of studies among industrial workers, we aim to study the association between anthropometric adiposity indices and the HGS of industrial workers.

Materials and Methods

The study is a descriptive, cross-sectional study. Anthropometric measurements and HGS of 198 male industrial workers between 21 and 60 years of age, employed at metal manufacturing industries in Chennai, Tamil Nadu, India were assessed.

Statistical Analysis

Descriptive and inferential statistics were done using "R" statistical software.

Results

The mean age of male industrial workers was 39.51 ± 12.20 years. The majority of the workers were found to be obese (64%) and the mean body fat percentage was 27.69 ± 5.13%. The mean HGS of the worker's dominant hand was found to be 35.80 ± 8.93 kg and of their non-dominant hand was 35.0 ± 8.67 kg. When compared to the normative values of HGS for Indians, results revealed significantly higher HGS of both dominant and non-dominant hands of workers between the age group of 21-30 years and 51-60 years. Multiple linear regression analysis revealed that body weight [β(s.e) =0.27 (0.05), P < 0.000], body fat [β(s.e) = -0.52 (0.14), P < 0.000) and WHR [β(s.e) = -28.81 (11.9), P = 0.017] independently predicted the HGS of dominant hand. In non-dominant hand, body weight [β(s.e) = 0.26 (0.05), P < 0.000] and body fat [β(s.e) = -0.60 (0.13), P < 0.000] independently predicted HGS.

Conclusions

Body fat, body weight, and Waist-to-Hip ratio (WHR) were found to have a significant influence on the HGS of industrial workers. Strategies aimed to reduce overall body fat and abdominal obesity may prove beneficial in improving HGS and nutritional status thereby reducing the risk of non-communicable diseases.

A Simple Device for Measuring Sit-to-Stand Movements and Cardio-Metabolic Diseases: A Cross-Sectional Study in a Health Check-Up Population Over 20 Years Old

Introduction Several studies have reported the usefulness of measuring lower limb muscle strength through the motion of standing up using a reaction force measuring device positioned on the ground. There is inadequate information on the association between cardiovascular disease risk factors and ground reaction force (GRF) during standing up. Therefore, this study estimated the association between GRF by sit-to-stand movements and cardiovascular disease risk factors in a health check-up population. Methods This cross-sectional study included 1,182 healthy participants without chronic diseases who underwent periodic health check-ups from August 2019 to December 2020. The study included individuals aged ≥20 years who underwent a standing test from an initial seated position in a chair. A sit-to-stand force analyzer was used to measure GRF, and health status information was collected at enrollment. The relationships between blood test data and each measurement obtained from GRF measurements (forth/body mass (F/M), rate of forth development/body mass (RFD/M), and stable time) were parsed according to sex using linear regression analysis coordinated by age. GRF measurements and their relationships with cardiovascular disease risk factors were assessed using logistic regression analysis, adjusted for age and sex. Results A total of 1,182 participants was included in this study, with male participants accounting for 61.5%. The study participants had a median age of 57.0 years (IQR: 47.0-63.0). After adjusting for age, F/M was positively associated with high-density lipoprotein cholesterol in male (β=22.59, p<0.001) and female participants (β=20.35, p=0.011) and negatively associated with plasma glucose in male (β=-16.25, p=0.008) and female participants (β=-18.78, p=0.028). Stable time (time required to be stabilize after standing up movement) was positively associated with hemoglobin A1c levels in male (β=0.55, p=0.001) and female participants (β=0.56, p=0.036). Logistic regression analysis adjusted by age and sex showed that a lower F/M ratio was associated with hypertension, hyperlipidemia, and diabetes mellitus (adjusted odds ratio (aOR) =1.60, p=0.01; aOR=1.75, p=0.001; and aOR=2.23, p=0.002, respectively). Lower RFD/M was associated with hyperlipidemia and diabetes mellitus (aOR=1.46, p=0.013 and aOR=1.63, p=0.045, respectively). A shorter stable time was associated with diabetes mellitus (aOR=0.39, p<0.001). Conclusions These findings suggest that lower limb function impairment, as assessed via standing-up movements using a GRF-measuring device, may relate to cardiovascular disease. Further research is needed to confirm this association.

Different sedentary behaviors, genetic susceptibility of hypertension, and new-onset hypertension: Mediating effects of body mass index and grip strength

BACKGROUND

The association between different sedentary behaviors and hypertension risk remains unclear. We aimed to explore the relationship between different domains of sedentary behaviors and new-onset hypertension, investigate whether genetic susceptibility to hypertension modifies the relationship, and examine the extent to which the relationship is mediated by body mass index (BMI) and grip strength.

METHODS

212 714 participants without baseline hypertension in the UK Biobank were enrolled. The three major sedentary behaviors (TV-watching, nonoccupational computer use, and driving) were measured using touch screen questionnaires. The primary outcome was new-onset hypertension.

RESULTS

During a median follow-up of 11.9 years, 13 983 participants developed hypertension. There was a linear positive association between TV-watching time and new-onset hypertension (p for nonlinearity =0.868). A J-shaped association was found for nonoccupational computer use time and driving time with new-onset hypertension, with an inflection point of 0.5 h/day for both (both p for nonlinearity <0.001). Polygenetic risk scores for hypertension (based on 118 related single-nucleotide polymorphisms) did not significantly modify these associations (all p-interactions >0.05). Furthermore, the detrimental effects of long-term sedentary behaviors on hypertension were mediated by BMI by 21%-30%, and the beneficial effects of limited sitting time (within 0.5 h/day) for driving and nonoccupational computer use were mediated by grip strength by 6-25%.

CONCLUSIONS

There was a positive association for hands-independence sedentary behavior (TV-watching), and a J-shaped association for hands-dependence sedentary behaviors (nonoccupational computer use and driving) with new-onset hypertension, regardless of genetic risks of hypertension. These relationships were partly mediated by BMI and grip strength.

Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp

Muscular strength represents a specific component of health-related fitness. Hand grip strength is used as a simple and dynamic marker of maximum voluntary force of the hand and to estimate overall strength. Today, little is known about the relationship between grip strength and health in forcibly displaced populations. In the present study, we examined whether grip strength is associated with various health outcomes in a sample of forcibly displaced people living in a Greek refugee camp. The present analyses are part of a larger pragmatic randomized controlled trial. In this paper, cross-sectional baseline data of 143 participants (71 men, 72 women) will be presented. In addition to grip strength, the following physical and mental health outcomes were assessed: body weight and body composition, blood pressure, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, blood glucose levels (HbA1c), post-traumatic stress disorder (PTSD) symptoms, depressive and anxiety symptoms, pain, and quality of life. Linear regression analyses were carried out to examine how grip strength is associated with the health outcomes, separately for absolute and normalized grip strength scores. Grip strength was positively and strongly associated with percentage muscle mass (normalized grip strength: Stand. B = 0.58, p < .001), whereas a negative association existed for percentage body fat (normalized grip strength: Stand. B = - 0.58, p < .001). No statistically significant associations occurred between grip strength and the other cardiovascular risk markers. In contrast, we found that participants with higher normalized grip strength reported higher levels of PTSD (normalized grip strength: Stand. B = 0.36, p < .05) and depressive symptoms (normalized grip strength: Stand. B = 0.29, p < .05). No significant association occurred between grip strength, anxiety, pain and quality of life. Measuring grip strength in forcibly displaced people can be a useful way to assess their overall muscle strength. Grip strength tests are easy to implement, and results can be used to assess the effects of specific intervention measures. Nevertheless, our results question the usefulness of grip strength as a marker of cardiovascular health and mental wellbeing in a refugee camp setting.

Muscle quality is negatively related to hypertension prevalence in adults: Results from NHANES 2011-2014

Resistance training could counter hypertension and improve muscle quality (MQ), but current evidence about the correlation between MQ and hypertension is limited. The authors aimed to explore this correlation using the data of participants aged 20-59 from NHANES 2011-2014 via a cross-sectional study. The MQ was quantified as handgrip strength (kg)/lean soft tissue mass (kg) of the dominant arm. Weighted multivariate logistic regression models were mainly utilized to investigate the MQ-hypertension association; linear trend tests and subgroup analysis were also conducted. Moreover, the authors employed weighted multivariate linear regression models to uncover the association between blood pressure (BP) and MQ. Four thousand four hundred and sixty-nine individuals were enrolled, and 1167 were hypertensive. Hypertensive participants had a lower MQ than normotensive participants. In the totally adjusted model, each unit elevation in MQ was related to a 7% reduction in hypertension prevalence (p =.002). There was a decreasing trend in hypertension prevalence and in systolic BP as the MQ increased from the bottom to the top quartile across all three models (p for trend ≤.01), with a 28% difference (OR: 0.72, 95% CI: 0.54, 0.95) in hypertension prevalence and a 1.88 mm Hg (95% CI: -3.56, -0.20) difference in SBP between the top and bottom quartiles in the fully adjusted model. Subgroup analysis further confirmed the MQ-hypertension inverse association. In conclusions, the MQ was negatively associated with hypertension prevalence and systolic BP, which suggests the MQ may be a protective factor for hypertension and need to be improved.

Association between anemia and grip strength indices combined with anthropometry in the Korean population

Anemia is common in older people and is associated with low hand grip strength (HGS). However, there is no study of the association of anemia with both absolute and various relative HGS indices. Therefore, the objectives of this study are to examine the association of anemia with absolute and relative HGS indices and to evaluate whether the relative HGS indices are useful as risk indices of anemia. In this large-scale cross-sectional study, we analyzed the association of anemia with anthropometric indices, absolute HGS indices, and relative HGS indices using both crude and adjusted binary logistic regression models. A total of 24,022 participants were included in the final analysis. Anemia was defined as a blood hemoglobin concentration of less than 13.0 g/dL for men, less than 11.0 g/dL for pregnant women, and less than 12.0 g/dL for nonpregnant women. We considered covariates such as residential area, marital status, education level, occupation, household income, alcohol consumption, smoking status, muscular exercise, walking exercise, blood pressure, and age for men, while for women, we also included menopause. The mean ages of the subjects in this study were 51.89 ± 0.19 years in the nonanemic group and 66.56 ± 0.61 in the anemic group in men and 52.55 ± 0.19 in the nonanemic group and 51.85 ± 0.44 in the anemic group in women. The number of anemic patients was 570 (5.5%) in men and 1638 (12%) in women. The mean HGS value in the dominant hand was 38.97 ± 0.11 in the nonanemic group and 30.84 ± 0.38 in the anemic group in men and 22.64 ± 0.07 in the nonanemic group and 21.85 ± 0.16 in the anemic group in women. Age was highly associated with anemia in men but not in women. Absolute HGS indices, such as the dominant HGS index and both HGS indices, were negatively associated with anemia in both sexes in all crude and adjusted models. All relative HGS indices were associated with anemia in men, but in women, only dominant HGS divided by height and both HGS divided by height were related to anemia status in all models. The associations between anemia and absolute and relative HGS indices were significantly high in men, while in women, these associations were of moderate strength. Anemia was negatively associated with HGS in the Korean population. The strengths of the associations of anemia with the absolute and relative HGS indices showing the highest association with anemia were similar. Therefore, there is no need to use relative HGS indices as risk factors for anemia, and absolute HGS indices, as easily obtained and cost-effective measurement, are suitable.

Association between relative muscle strength and hypertension in middle-aged and older Chinese adults

BACKGROUND

The association between muscle defects and hypertension is well-established. However, the absence of pertinent and uncomplicated clinical indicators presents a challenge. Relative muscle strength (RMS) may offer a viable indicator. This study aimed to explore the association between RMS and hypertension.

METHODS

A total of 12,720 individuals aged ≥ 45 years from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. Grip strength was recorded and appendicular skeletal muscle mass (ASM) was estimated using a validated mathematical formula. The RMS was calculated as the ratio of grip strength to ASM. Hypertension was determined based on previous diagnosis, history of hypertension medication use, and current blood pressure. Logistic regression models were employed to investigate the relationship between RMS and hypertension.

RESULTS

The prevalence of hypertension was 41.7% (5,307/12,720 patients). RMS was negatively correlated with hypertension with an OR (95% CI) of 0.68 (0.59-0.79) for males, 0.81 (0.73-0.90) for females, and 0.78 (0.72-0.85) for the entire population after adjusting for related covariates including age, education, marital history, smoking history, drinking history, diabetes, hyperlipidemia, and obesity. The trend test showed a linear association among males, females, or the entire population. Stratified analysis showed a consistent negative correlation between RMS and hypertension.

CONCLUSIONS

Higher RMS is an independent protective factor against hypertension and efforts to promote RMS may be beneficial for the prevention and management of hypertension.

Effects of intervention integrating physical literacy into active school recesses on physical fitness and academic achievement in Chinese children

Background/Objective

The aim of this study was to examine the effects of school-based intervention integrating physical literacy (PL) into active school recesses (ASR) on physical fitness (i.e., body composition, 20-m shuttle run, 50-m run, rope skipping, sit and reach, handgrip) and academic achievement (i.e., academic result of Chinese and Mathematics) in Chinese children.

Methods

A total of 357 children (mean age: 7.8 ± 0.7 years; boys: 50.4%) were recruited from two schools and these two schools were randomly assigned as the intervention group (IG) and the control group (CG), respectively. The IG consisted of 155 children (mean age: 7.9 ± 0.7 years, boys: 51.0%), and 202 children (mean age: 7.8 ± 0.7 years; boys: 50%) were allocated to the CG. Children in the IG received a 10-week intervention integrating PL that was conducted during ASR. In the CG, children's regular school activity was remained during the intervention period. Generalized estimating equation was performed to compare the levels of physical fitness and academic achievement between the IG and the CG after intervention.

Results

Regarding physical fitness, there was a significant group × time interaction on 20-m shuttle run (β = -3.89, 95% CI [-5.08; -2.71], p < 0.001) and handgrip (β = -0.70, 95% CI [-1.20; -0.20], p = 0.006). After intervention, children in the IG had a greater increase than the CG (p < 0.001) in terms of 20-m shuttle run and handgrip. In addition, the post-test analysis indicated that performance of children in the IG was significantly greater than those in the CG (20-m shuttle run: p < 0.001, handgrip: p = 0.002). There was a significant group × time interaction on academic result of Chinese (β = -1.21, 95% CI [-1.91; -0.56], p = 0.001) and academic result of Mathematics (β = 16.71, 95% CI [15.14; 18.143], p < 0.001). Statistically significant positive difference in post-test was observed in academic result of Mathematics between the IG and the CG (p = 0.012).

Conclusion

The results of this intervention study indicate that intervention integrating PL into ASR could bring a promising effect on physical fitness and academic achievement in children. It is recommended that future studies are necessary to assess the effects of ASR-based PL intervention on physical and cognitive outcomes using a wide range of sample.

Sit to stand test and handgrip strength in men and women with post-COVID-19 syndrome without invasive ventilator support: insights from a Brazilian observational study

Two valid tests have been used in patients with post-COVID-19 syndrome (coronavirus disease 2019) due to their fast application, feasibility, and accessible procedures, facilitating data collection in large groups: the 1-minute sit-to-stand test (STS) and handgrip strength (HGS) dynamometry. The present study aimed to: i) assess the STS and HGS in men and women with post-COVID-19 syndrome who did not require invasive ventilator support; ii) correlate STS repetitions and HGS with time since the COVID-19 diagnosis. Six hundred and twenty-two men and women with post-COVID-19 syndrome who did not require invasive ventilatory support performed the STS and HGS tests at the beginning of the rehabilitation process at a Reference Hospital Centre. Women over 55 years presented significantly lower results compared to participants under 55 years. For the HGS, the median ranged from 42 to 48 kg and 70 to 81 kg for the female and male groups, respectively. The correlations of time since COVID-19 diagnosis with STS and HGS ranged from -0.16 to 0.02 (p>0.05) for women and men, respectively.The test results could be used for the initial analysis of normality ranges and comparisons with other populations. Although STS repetitions and HGS presented low and non-significant correlations with time since the COVID-19 diagnosis, some COVID-19 sequelae were not measured, so these data should be interpreted with caution.

Establishment of hypertension risk nomograms based on physical fitness parameters for men and women: a cross-sectional study

Objective

This study aims to establish hypertension risk nomograms for Chinese male and female adults, respectively.

Method

A series of questionnaire surveys, physical assessments, and biochemical indicator tests were performed on 18,367 adult participants in China. The optimization of variable selection was conducted by running cyclic coordinate descent with 10-fold cross-validation through the least absolute shrinkage and selection operator (LASSO) regression. The nomograms were built by including the predictors selected through multivariable logistic regression. Calibration plots, receiver operating characteristic curves (ROC), decision curve analysis (DCA), clinical impact curves (CIC), and net reduction curve plots (NRC) were used to validate the models.

Results

Out of a total of 18 variables, 5 predictors-namely age, body mass index, waistline, hipline, and resting heart rate-were identified for the hypertension risk predictive model for men with an area under the ROC of 0.693 in the training set and 0.707 in the validation set. Seven predictors-namely age, body mass index, body weight, cardiovascular disease history, waistline, resting heart rate, and daily activity level-were identified for the hypertension risk predictive model for women with an area under the ROC of 0.720 in the training set and 0.748 in the validation set. The nomograms for both men and women were externally well-validated.

Conclusion

Gender differences may induce heterogeneity in hypertension risk prediction between men and women. Besides basic demographic and anthropometric parameters, information related to the functional status of the cardiovascular system and physical activity appears to be necessary.

One-Year Handgrip Strength Change in Kindergarteners Depends upon Physical Activity Status

Free play in kindergarten can be roughly divided into fine and gross motor activities, but the effects of these activities on improving handgrip strength are unknown. Therefore, we aimed to compare one-year changes in handgrip strength and forearm flexor muscle size in children separated by preferred play in a kindergarten. One hundred and eleven children were recruited from a local kindergarten. They underwent handgrip strength and forearm muscle thickness measurements, and 95 (49 boys and 46 girls) underwent a second measurement one year after the first measurement. Class teachers assessed the physical activity of everyone in their class after the second measurement. Using three evaluation scores by the class teachers, we divided children into three groups based on the children's preference to play in kindergarten (fine movement vs. gross motor movement). Handgrip strength did not change differently between groups across one year. However, children who liked active playing outside (i.e., gross motor activity) were stronger than others. Furthermore, children who like playing outside observed greater changes than the other groups in the ulna (right hand) and radius muscle thickness (left hand), suggesting that changes in forearm muscle size might be incongruent with changes in handgrip strength among the three activity groups.

Relationship Between Handgrip Strength and Age in the Body Composition Variables Among People Living with HIV

BACKGROUND

The study of aging and handgrip strength (HGS) is important to gain knowledge regarding health care and quality of life in people living with HIV (PLHIV).

OBJECTIVE

The aim of the study is to analyze the relationship between HGS and age in the body composition variables of PLHIV.

METHODS

The sample consisted of 77 PLHIV, divided into three groups: G40 - PLHIV aged 40-49 years (n=39); G50 - PLHIV aged 50-59 years (n=26); and G60 - PLHIV aged 60-69 years (n=12). Data collection included anamnesis (sociodemographic, clinical, and laboratory information), physical assessment (body composition and HGS), and physical activity level. Data were analyzed by descriptive and inferential statistics.

RESULTS

It was noted that men, compared to women, are 5.85 times more likely to present adequate HGS (p<0.001). In addition, adequate HGS was associated with adequate values of body mass index (p<0.001), waist circumference (p<0.001), and fat percentage (p<0.001). The G40 and G50 groups, in relation to the G60, were associated with adequate abdominal circumference (p=0.04).

CONCLUSION

Monitoring the evolution of HGS in PLHIV, over time, makes it possible to infer about body fat and muscle mass, in order to propose prevention actions and guidelines to prevent early muscle loss, the development of overweight/obesity, and abdominal obesity.

The Influence of the BDNF Val66Met Variant on the Association Between Physical Activity/Grip Strength and Depressive Symptoms in Persons With Diabetes

The rs6265 in the brain-derived neurotrophic factor (BDNF) is associated with depression in people with diabetes. Both physical activity (PA) and grip strength are negatively associated with depression. We conducted cross-sectional analyses of the wave 10 survey data for a nationally representative sample of 1,051 diabetes participants of the Health and Retirement Study. Both greater PA (β = -.15) and stronger grip strength (β = -.02) were independently associated with depression. Although the interaction between BDNF rs6265 and PA on depressive symptoms was not significant, the negative PA-depression association was stronger among female non-Met carriers (β = -.19) and male Met carriers (β = -.14). Meanwhile, grip strength was associated with depression only in Met carriers (β = -.04), and similar association was observed in both males and females. In conclusion, female non-Met carriers and male Met carriers may benefit from PA.

Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population

OBJECTIVE

This study investigated the association between relative hand grip strength (HGS) and glycemic status, such as impaired fasting glucose (IFG) and diabetes, using data from the Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

We performed a cross-sectional study using the data from the KNHANES of 27,894 individuals from 2014 to 2019. Relative HGS was defined as the absolute HGS divided by body mass index and divided into quartiles in men and women. Odds ratios (OR) for diabetes and IFG were calculated using multivariate logistic regression analysis. All analyses were stratified by sex, and subgroup analysis was age-stratified.

RESULTS

The lowest relative HGS quartile had a significant increase in the risk for diabetes (men: OR 2.72, 95% confidence interval [CI] 2.12-3.50; women: OR 3.38, 95% CI 2.70-4.24) and IFG (men: OR 1.35, 95% CI 1.15-1.59; women: OR 1.60, 95% CI 1.40-1.84). The ORs for diabetes and IFG according to the decreasing quartiles of relative HGS gradually increased in both sexes (P for trend <0.001). ORs and 95% CI of the lowest relative HGS quartile for diabetes were higher in the younger age group than that of the older age group (men: 4.47 and 2.80-7.14 for young adults; 2.41 and 1.37-4.25 for older adults; women: 5.91 and 3.06-9.38 for young adults; 1.47 and 0.92-2.33 for older adults). ORs and 95% CI for IFG was similar with the trend of ORs for diabetes (men: 1.80 and 1.43-2.26 for young adults; 1.17 and 0.75-1.84 for older adults; women: 2.20 and 1.77-2.72 for young adults; 1.33 and 0.86-2.07 for older adults).

CONCLUSION

Lower relative HGS was associated with a higher risk of not only diabetes but also IFG in both sexes. These trends were stronger in younger adults than in older adults.

Thresholds for clinical practice that directly link handgrip strength to remaining years of life: estimates based on longitudinal observational data

OBJECTIVE

Muscle strength is a powerful predictor of mortality that can quickly and inexpensively be assessed by measuring handgrip strength (HGS). What is missing for clinical practice, however, are empirically meaningful cut-off points that apply to the general population and that consider the correlation of HGS with gender and body height as well as the decline in HGS during processes of normal ageing. This study provides standardised thresholds that directly link HGS to remaining life expectancy (RLE), thus enabling practitioners to detect patients with an increased mortality risk early on.

DESIGN

Relying on representative observational data from the Health and Retirement Study, the HGS of survey participants was z-standardised by gender, age and body height. We defined six HGS groups based on cut-off points in SD; we use these as predictors in survival analyses with a 9-year follow-up and provide RLE by gender based on a Gompertz model for each HGS group.

PARTICIPANTS

8156 US American women and men aged 50-80 years.

MAIN OUTCOME MEASURES

Z-standardised HGS and all-cause mortality.

RESULTS

Even slight negative deviations in HGS from the reference group with [0.0 SD, 0.5 SD) have substantial effects on survival. RLE among individuals aged 60 years with standardised HGS of [-0.5 SD, 0.0 SD) is 3.0/1.4 years lower for men/women than for the reference group, increasing to a difference of 4.1/2.6 years in the group with HGS of [-1.0 SD, -0.5 SD). By contrast, we find no benefit of strong HGS related to survival.

CONCLUSIONS

HGS varies substantially with gender, age and body height. This confirms the importance of considering these heterogeneities when defining reference groups and risk thresholds. Moreover, survival appears to decrease at much higher levels of muscle strength than is assumed in previous literature, suggesting that medical practitioners should start to become concerned when HGS is slightly below that of the reference group.

Is grip strength linked to body composition and cardiovascular risk markers in primary schoolchildren? Cross-sectional data from three African countries

OBJECTIVES

Muscular strength represents a specific component of health-related fitness. Hand grip strength (HGS) is used as an indicator for musculoskeletal fitness in children. HGS can also be used as a marker of cardiometabolic risk, but most available HGS data are derived from Western high-income countries. Therefore, this study examines whether HGS is associated with body composition and markers of cardiovascular risk in children from three sub-Saharan African countries.

DESIGN

Cross-sectional study.

SETTING

Public primary schools (grade 1-4) in Taabo (Côte d'Ivoire), Gqeberha (South Africa) and Ifakara (Tanzania).

PARTICIPANTS

Data from 467 children from Côte d'Ivoire (210 boys, 257 girls), 864 children from South Africa (429 boys, 435 girls) and 695 children from Tanzania (334 boys, 361 girls) were analysed.

PRIMARY AND SECONDARY OUTCOME MEASURES

Body composition (assessed via bioelectrical impedance analysis) was the primary outcome. Cardiovascular risk markers were considered as secondary outcome. Blood pressure was measured with an oscillometric monitor, and blood markers (cholesterol, triglycerides, glycated haemoglobin) via Afinion point-of-care testing. HGS (independent variable) was assessed with a hydraulic hand dynamometer. Inferential statistics are based on mixed linear regressions and analyses of covariance.

RESULTS

Across all study sites, higher HGS was associated with lower body fat, higher muscle mass and higher fat-free mass (p<0.001, 3.9%-10.0% explained variance), both in boys and girls. No consistent association was found between HGS and cardiovascular risk markers.

CONCLUSIONS

HGS assessment is popular due to its simplicity, feasibility, practical utility and high reliability of measurements. This is one of the first HGS studies with children from sub-Saharan Africa. There is a great need for further studies to examine whether our findings can be replicated, to develop reference values for African children, to establish links to other health outcomes, and to explore whether HGS is associated with later development of cardiovascular risk markers.

TRIAL REGISTRATION NUMBER

ISRCTN29534081.

Association between handgrip strength and body composition, physical fitness, and biomarkers in postmenopausal women with metabolic syndrome

OBJECTIVES

This study examined the association between handgrip strength and body composition, physical fitness, and biomarkers in postmenopausal women with metabolic syndrome.

METHODS

A total of 75 postmenopausal women were diagnosed with metabolic syndrome participated in this study. Muscle strength was assessed via a hydraulic grip strength dynamometer; physical fitness tests included a timed-up-and-go, arm curl test, and 30-s chair stand. Body composition was assessed via bioelectrical impedance, from which estimates of fat mass, body fat percentage, fat-free mass, and visceral fat area were determined. Fasting plasma glucose and glycated hemoglobin were measured via blood sample analyses. Multiple linear regression analyses were conducted using handgrip strength as the dependent variable and using body composition, physical fitness, and biomarkers as independent variables.

RESULTS

The results revealed that 52% of the total sample were classified as obese, 37.3% as overweight, and only 10.7% as normal weight. Significant correlations were present between handgrip strength and fat-free mass (p=0.002; R=0.590), mean blood pressure (p=0.002; R=0.450), and arm curl (p=0.001; R=0.795).

CONCLUSION

This study showed that handgrip strength was predictive of fat-free mass, blood pressure, and upper limb strength performance.

Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level

BACKGROUND

A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries.

METHODS

We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE)-Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension.

RESULTS

The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites-26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence.

CONCLUSIONS

We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

The combination of cardiorespiratory fitness and muscular fitness, and prevalence of diabetes mellitus in middle-aged and older men: WASEDA'S Health Study

Background

Although the negative relationship between cardiorespiratory fitness (CRF) or muscular fitness and diabetes mellitus were respectively observed in many previous studies, there is still a lack of studies that include CRF and muscular fitness simultaneously. Therefore, this study aimed to investigate the relationship between the combination of CRF and muscular fitness and diabetes through a cross-sectional study. 

Methods

This study was part of WASEDA'S Health Study, a cohort study launched in 2014. We used a part of the baseline data collected for this study. Maximal exercise test using a cycle ergometer and leg extension power (LEP) test were respectively used to evaluate CRF and muscular fitness. Since LEP is affected by body weight, relative LEP (rLEP) which is LEP per body weight, was used as an index of muscular fitness. 796 men (56.5 ± 10.4 years old) who completed a medical examination and fitness tests, were divided into two groups based on CRF and rLEP, respectively. The prevalence of diabetes was collected based on a self-reported questionnaire or blood test. Odds ratios and 95% confidence intervals (CIs) for the prevalence of diabetes were obtained using logistic regression models while adjusting for age, body mass index, exercise habits, family history of diabetes, smoking habits, and drinking habits.

Results

55 (7%) participants had diabetes. Compared to participants with lower CRF or rLEP, the odds ratio (95% CIs) of diabetes in those with higher CRF or rLEP was 0.46 (0.21–0.98) or 0.34 (0.16–0.74), respectively. Furthermore, using the lower CRF and lower rLEP group as the reference, the odds ratio (95% CIs) for the lower CRF and higher rLEP group was 0.32 (0.12–0.88), and higher CRF and higher rLEP group was 0.21 (0.07–0.63), after adjusting for potential confounding factors.

Conclusions

CRF and rLEP have independent and joint inverse associations with diabetes prevalence. In addition, participants with high CRF and high rLEP had a lower prevalence of diabetes compared to those with only high CRF or only high rLEP.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12971-x.

Handgrip Strength-Related Factors in a Colombian Hypertensive Population: A Cross-Sectional Study

(1) Background: This study determined the factors associated with manual grip strength in people with high blood pressure (HBP); (2) Methods: 219 subjects participated in this cross-sectional study, which evaluated muscle strength (manual dynamometer), sociodemographic factors, clinical characteristics, level of physical activity (International Physical Activity Questionnaire-IPAQ score), and depression (Zung's Depression Self-Rating Scale); (3) Results: The bivariate analysis found that handgrip strength in people with HPB was associated with sex (p = 0.000), age (p = 0.000), ethnicity (p = 0.019), smoking habits (p = 0.037), alcohol consumption (p = 0.004), diastolic blood pressure (p = 0.012), weight (p = 0.000), height (p = 0.000), measurement of waist circumference (p = 0.002), depression (p = 0.041), and IPAQ score (p = 0.000). Regardless of being male or female, handgrip strength was associated with age (p = 0.009), IPAQ (p = 0.000), weight (p = 0.038), height (p = 0.000), DPB units (p = 0.043), and depression (p = 0.020). The multivariate generalized linear gamma regression model showed that the coefficient with the greatest weight, regardless of sex, was age (p = 0.043), level of physical activity (24% more at high level than at low level, p = 0.031), and depression (moderate/severe depression level) associated with lower handgrip strength (p = 0.025); (4) Conclusions: Handgrip strength showed an association with level of physical activity, age, and level of depression in a middle-aged population with HBP.

The independent and joint associations between muscle strength, health variables and cardiovascular disease among adults

OBJECTIVES

We investigated the independent and joint association between muscle strength and health variables according to individual health status among adults.

METHODS

Cross-sectional population-based study comprising 643 adults (39.6 ± 11.1 years, 44.9% men) from Florianópolis, Southern Brazil. Muscle strength was assessed by handgrip strength. Health variables included were systolic (SBP) and diastolic blood pressure (DBP), waist circumference (WC), carotid intima-media thickness (IMT), high-sensitivity C-reactive protein (CRP), total cholesterol (CHOL), HDL cholesterol (HDL-C), triglycerides (TRG), glycated hemoglobin (HbA1c), and insulin resistance index (HOMA-IR). Participants were grouped into three health status categories: 1) healthy (without CVD and risk for CVD); 2) at risk for CVD (obesity, high blood pressure, and hyperglycemia); 3) with CVD. Multiple linear regression adjusted for confounding factors was used.

RESULTS

Muscle strength was inversely associated with IMT (β = -0.02, SE: 0.03), CHOL (β = -0.14, SE: 0.02) and HbA1c (β = -0.01, SE: 0.10), and directly associated with SBP (β = 0.16, SE: 0.06) and WC (β = 0.02, SE: 0.03). Among adults with CVD, muscle strength was inversely associated with IMT (p < 0.05). Higher muscle strength was directly associated with SBP among healthy adults (p < 0.05).

CONCLUSION

The main finding of the present study indicated that among individuals with CVD, muscle strength was associated with lower IMT values.

Mental Health and Handgrip Strength Among Older Adults: A Nationwide Study

Handgrip strength is used as an important indicator of health in older adults. We aimed to explore the association between stress, depression, and suicidal ideation and handgrip strength among older adults. We conducted this cross-sectional study involving 1254 individuals (aged ≥65 years), using data from the 2015 Korean National Health and Nutrition Examination Survey VI. We used logistic regression analysis to examine associations between handgrip strength and mental health. Among mental health factors, a significant difference was noted between stress and handgrip strength among the older adults. After adjusting for confounding factors, the odd ratio (OR) of stress among older adults with low handgrip strength was statistically significant in Models 1 (1.61 (95% CI: 1.01–2.57)) and 2 (1.59 (95% CI: 1.01–2.52)) but not in Model 3 (1.52 (95% CI: .96–2.43)). No significant association was found between depression or suicidal ideation and handgrip strength. The risk of stress was 1.59-1.61 times higher in older adults with low handgrip strength, compared to that in older adults with normal handgrip strength. It is necessary to develop strategies aimed at managing stress among older adults with low handgrip strength and educating them about the importance of handgrip strength and exercises that increase handgrip strength.

Lower handgrip strength levels probably precede triglyceride glucose index and associated with diabetes in men not in women

AIMS/INTRODUCTION

To explore the relationship between handgrip strength per weight (HGS/W), triglyceride glucose index (TyG) and diabetes, and whether lower HGS levels precede TyG in the Chinese elderly population.

MATERIALS AND METHODS

Two linear regression models were used to explore the association of whether baseline HGS/W predicted follow-up variation of TyG or baseline TyG predicted follow-up variation of HGS/W. The logistic regression model was used to examine the relationship between baseline HGS/W and future diabetes.

RESULTS

A total of 4,561 participants in the China Health and Retirement Longitudinal Study were enrolled, of which 47.0% were men, and the mean age was 58.7 years (standard deviation 8.68 years). A lower baseline HGS/W significantly correlated with a higher level of follow-up TyG (β = -0.173, P = 0.002). The baseline level of HGS/W was significantly negatively associated with the incidence risk of diabetes (rate ratio 0.375, P = 0.004). However, in sex stratification, the statistical association between HGS/W and TyG and diabetes was only in men.

CONCLUSIONS

Our results showed that HGS/W was inversely associated with TyG and diabetes, and lower HGS/W levels preceded TyG levels in the elderly population. However, the effect was inconsistent between men and women, and the possible mechanism would require further clarification.

Intakes of Total and Branched-Chain Essential Amino Acids are Positively Associated with Handgrip Strength in African American and White Urban Younger and Older Adults

Essential amino acids (EAAs) initiate amino acid-induced stimulation of muscle protein synthesis. Study objectives were to calculate intake of EAAs after creating an EAA database, to explore the association of EAAs and branched-chain amino acids (BCAAs) with handgrip strength (HS) in a younger (<50 y) and older (≥50 y) sample, and to identify major food groups contributing EAAs. The sample consisted of African American and White adults aged, 33-71 years from the Healthy Aging in Neighborhoods of Diversity across the Life Span study, 2009-2013. Intake of total EAAs and BCAAs/kg body weight were positively associated (p < 0.001) with HS per body mass index (HS/BMI) ratio. Being male, African American, a nonsmoker, physically active, euglycemic, and normotensive were associated with higher HS/BMI ratio. EAAs were mainly obtained from red meats/poultry and mixed dishes groups. Findings support the role of high-quality proteins and being active in promoting HS.

The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: Findings from the Prospective Urban Rural Epidemiology China Study

BACKGROUND

Both hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect CVD and all-cause mortality is unknown. This study sought to investigate the associations of GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality in patients with hypertension.

METHODS

GS was measured using a Jamar dynamometer (Sammons Preston, Bolingbrook, IL, USA) in participants aged 35-70 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study. Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.

RESULTS

Among 39,862 participants included in this study, 15,964 reported having hypertension, and 9095 had high GS at baseline. After a median follow-up of 8.9 years (interquartile range, 6.7-9.9 years), 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (hazard ratio (HR) = 2.39; 95% confidence interval (95%CI): 1.86-3.06; p < 0.001) or CVD mortality (HR = 3.11; 95%CI: 1.59-6.06; p < 0.001) but did not have a significantly increased risk of all-cause mortality (HR = 1.24; 95%CI: 0.92-1.68; p = 0.159). These risks were further increased if hypertensive participants whose GS level was low (major CVD incidence, HR = 3.31, 95%CI: 2.60-4.22, p < 0.001; CVD mortality, HR = 4.99, 95%CI: 2.64-9.43, p < 0.001; and all-cause mortality, HR = 1.93, 95%CI: 1.47-2.53, p < 0.001).

CONCLUSION

The present study demonstrates that low GS is associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality among hypertensive patients. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.

Association Between Relative Quadriceps Strength and Type 2 Diabetes Mellitus in Older Adults: The Yangpyeong Cohort of the Korean Genome and Epidemiology Study

BACKGROUND

To examine the independent and combined association between relative quadriceps strength and the prevalence of type 2 diabetes mellitus (T2DM) in older adults.

METHODS

Among 1441 Korean older adults aged ≥65 years (71 [4.7] y) recruited between 2007 and 2016, 1055 older adults with no history of myocardial infarction, stroke, or cancer were included in the analysis. Cases of T2DM were identified by self-reported physician diagnosis, use antihyperglycemic medication or insulin, or fasting blood glucose ≥126 mg/dL. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of T2DM by quartiles of relative quadriceps strength.

RESULTS

There were 162 T2DM cases (15%). Compared with the lowest quartile (weakest), the odds ratios (95% confidence intervals) of T2DM were 0.56 (0.34-0.90), 0.60 (0.37-0.96), and 0.47 (0.28-0.80) in the second, third, and fourth quartiles, respectively, after adjusting for possible confounders, including body mass index. In the joint analysis, compared with the "weak and overweight/obese" group, the odds (odds ratios [95% confidence intervals]) of T2DM was only lower in the "strong and normal weight" group (0.36 [0.22-0.60]) after adjusting for possible confounders.

CONCLUSIONS

Greater relative quadriceps strength is associated with reduced odds of T2DM in older adults after adjusting for potential confounders including body mass index.

Association of skeletal muscle and cardiovascular risk factors in patients with lower extremity arterial disease

BACKGROUND

Sarcopenia is defined as low muscle mass, with low muscle strength or low physical performance. The skeletal muscle mass (or density) and strength are inversely associated with cardiovascular risk factors. We aim to determine the relationship between skeletal muscle characteristics (strength, mass, area), and cardiovascular risk factors in a population with lower extremity artery disease (LEAD) METHODS: : An observational, prospective study including patients with LEAD was conducted from January 2018 to December 2020. The cardiovascular risk factors and anthropometric measurements were prospectively registered. The skeletal muscle characteristics (area, density/mass and strength) were analysed. The skeletal muscle area and density were quantified with a CT scan. The strength was determined with a Jamar® hydraulic hand dynamometer.

RESULTS

96 patients with LEAD with 67.70± 10.11 years-old were enrolled in the study. The most prevalent cardiovascular risk factor was hypertension, followed by dyslipidemia and diabetes. Patients with diabetes had a lower handgrip strength and skeletal muscle density, when compared with patients without diabetes (strength: 19.67± 9.98 kgf versus 26.79 ± 11.80 kgf, p=0.002 and skeletal muscle density: 10.58 ± 17.61 HU versus 18.17 ± 15.33 HU, p=0.032). There was a trend for the association between the presence of cardiovascular risk factors (hypertension and dyslipidemia) and a decrease in skeletal muscle density and strength (density: hypertension: 13.46 ± 16.74 HU versus 20.38 ± 11.63 HU p=0.055; dyslipidemia: 13.57 ± 17.16 HU versus 17.74 ± 13.00 HU p=0.315; strength- hypertension: 22.55 ± 10.08 kgf versus 27.58 ± 15.11 p= 0.073; dyslipidemia: 22.80 ± 10.52 kgf versus 25.28 ± 13.14 kgf p=0.315). Interestingly, we found that smokers had a favorable skeletal muscle characteristic, which could be explained by the higher prevalence of diabetes in non-smokers.

CONCLUSIONS

The indicators of skeletal muscle dysfunction (strength and density) are associated to the presence of diabetes in patients with LEAD. Therapeutic strategies to improve the skeletal muscle characteristics could have a role in improving LEAD risk factors, particularly diabetes.

Association between Adjusted Handgrip Strength and Metabolic Syndrome in Arab Men

This cross-sectional study determined the association between handgrip strength (HGS) and metabolic syndrome (MetS) in Arab men. Furthermore, HGS and adjusted HGS, relative to body composition components including body mass index (BMI), body weight, and body fat percentage (%Fat), were examined in predicting MetS. Methods: In this study, 854 men participated in and completed all tests (age, 39.7 ± 15.2 years; BMI, 28.4 ± 5.2 kg/m²; %Fat, 26.6% ± 7.1%). Body composition and HGS were measured using a body impedance analyzer and a manual spring-type dynamometer, respectively. About 10 cc of venous blood was drawn once after overnight fasting and analyzed using the colorimetric method. MetS included waist circumference (WC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), blood pressure (BP), and fasting glucose were defined for the current specific population. Results: The receiver operating characteristics curve (ROC curve) showed an area under the curve (AUC) of HGS = 0.54, and 0.70 for HGS/%Fat. Linear regression analysis showed that the R² values for all three models were low in predicting MetS and its components. Lastly, the odds ratio of adjusted HGS showed that there were significant differences between all quartiles of MetS compared with the reference quartile (Q1), whereas HGS alone did not show such differences. A significant difference between the quartiles of HGS and adjusted HGS was observed in Q4 for glucose, and significant differences were also found from Q2 for hypertension in terms of the HGS and adjusted HGS. Conclusion: HGS could have protective potential for increased levels of glucose and systolic blood pressure, and using adjusted HGS rather than HGS alone is recommended for the association of MetS in Arab men.

Role of handgrip strength in predicting new-onset diabetes: findings from the survey of health, ageing and retirement in Europe

BACKGROUND

Diabetes is a major concern for the global health burden. This study aimed to investigate the relationship between handgrip strength (HGS) and the risk of new-onset diabetes and to compare the predictive abilities between relative HGS and dominant HGS.

METHODS

This longitudinal study used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), including 66,100 European participants aged 50 years or older free of diabetes at baseline. The Cox proportional hazard model was used to analyze the relationship between HGS and diabetes, and the Harrell's C index, net reclassification index (NRI), and integrated discrimination improvement (IDI) were calculated to evaluate the predictive abilities of different HGS expressions.

RESULTS

There were 5,661 diabetes events occurred during follow-up. Compared with individuals with lowest quartiles, the hazard ratios (95 % confidence intervals) of the 2nd-4th quartiles were 0.88 (0.81-0.94), 0.82 (0.76-0.89) and 0.85 (0.78-0.93) for dominant HGS, and 0.95 (0.88-1.02), 0.82 (0.76-0.89) and 0.60 (0.54-0.67) for relative HGS. After adding dominant HGS to an office-based risk score (including age, gender, body mass index, smoking, and hypertension), the incremental values of the Harrell's C index, NRI, IDI of relative HGS were all slightly higher than those of dominant HGS in both training and validation sets.

CONCLUSIONS

Our findings supported that HGS was an independent predictor of new-onset diabetes in the middle-aged and older European population. Moreover, relative HGS exhibited a slightly higher predictive ability than dominant HGS.

Evaluation of cardiometabolic profile in Health Professionals of Latin America

OBJECTIVE

To evaluate presence of risk factors for cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2) in a group of health care workers.

METHODS

During the X Latin American Congress of Internal Medicine held in August 2017, in Cartagena, Colombia, attendees were invited to participate in the study that included a survey on medical, pharmacological and family history, lifestyle habits, blood pressure measurement, anthropometry, muscle strength and laboratory studies. The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes, respectively.

RESULTS

Among 186 participants with an average age of 37.9 years, 94% physicians (52.7% specialists), the prevalence of hypertension was 20.4%, overweight 40.3%, obesity 19.9%, and dyslipidemia 67.3%. 20.9% were current smokers or had smoked, and 60.8% were sedentary. Hypertensive patients were found to be older, had higher Body Mass Index (BMI), higher waist circumference, higher waist-to-hip ratio, higher of body fat and visceral fat, smoked more and had lower muscle strength (high jump: 0.38 vs. 0.42̊cm; p̊=̊0.01). In 44.3% of participants was observed a high-risk score for CVD. The prevalence of diabetes was 6.59% and 27.7% were at risk.

CONCLUSION

The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population. The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low. It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population.

Handgrip strength as a predictor of incident hypertension in the middle-aged and older population: The TCLSIH cohort study

OBJECTIVES

The independent role of muscular strength in the prevention of chronic disease is increasingly being recognized. However, no cohort study has assessed the relationship between handgrip strength and the incidence of hypertension among the middle-aged and older population. The aim of this prospective cohort study was to investigate whether handgrip strength is related to incident hypertension among people aged 40 years and over.

STUDY DESIGN

This prospective cohort study (n = 8,480) was performed between 2013 and 2019 as part of the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study, Tianjin, China.

MAIN OUTCOME MEASURES

Participants without baseline hypertension were followed up for ~6 years (median 4.0 years). Hypertension was defined according to the JNC7 criteria. Handgrip strength was measured using a hydraulic handheld dynamometer. Adjusted Cox proportional hazards regression models were used to assess the relationships between weight-adjusted handgrip strength and the risk of incident hypertension.

RESULTS

The incidence rate of hypertension per 1000 person-years was 70. The fully adjusted hazards ratios (95% confidence interval) of the incidence of hypertension for increasing quartiles of weight-adjusted handgrip strength were: 1.00(reference), 0.84 (0.75-0.95), 0.78 (0.69-0.88), and 0.66 (0.58-0.75) (P for trend<0.0001). Moreover, the adjusted hazards ratio (95% confidence interval) of incident hypertension for per unit increase in weight-adjusted handgrip strength was 0.17 (0.10-0.27) (P<0.0001). Similar results were observed in males and females.

CONCLUSIONS

The present cohort study is the first to find that high weight-adjusted handgrip strength, but not absolute handgrip strength, is significantly and independently related to low risk of incident hypertension among the middle-aged and older population.

Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study

OBJECTIVES

This study was to determine the incidence of falls and identify baseline factors increased risk for incident falls over time among people with diabetes.

DESIGN

This study was a secondary analysis using the baseline and 4 years of follow-up data from the China Health and Retirement Longitudinal Study (CHARLS).

SETTING

A nationally representative survey of 17 500 Chinese residents aged 45 years and older were recruited in the baseline national survey in 2011. These participants were followed up every 2 years.

PARTICIPANTS

A total of 1238 middle-aged and older adults with diabetes and no history of falls at baseline were included in the current study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Information on incidence of falls and medical treatment resulting from falls were determined by self-report.

RESULTS

The findings showed that the incidence of falls was 29.4% during 4 years of follow-up. Participants with incident falls were younger, were more likely to be women, had lower education level and were less likely to be current drinkers. In addition, former drinkers were 2.22 times more likely to fall. Socially active individuals were 47% less likely to fall compared with those without social activities. Every 5 kg increase in grip strength was associated with a 13% lower risk of falls. A 10 mg/dL higher total cholesterol and 1 mg/dL higher blood urea nitrogen were associated with a 4% and 6% higher risk of falls. Finally, participants with depressive symptoms were 1.47 times more likely to fall compared with those without depressive symptoms.

CONCLUSIONS

These findings underscore the importance of developing a fall prevention programme for those with diabetes, and this programme should address potentially modifiable risk factors, including levels of total cholesterol, blood urea nitrogen, social activity, depressive symptoms and grip strength.

Handgrip and sex-specific cardiometabolic risk factors in Hispanic/Latino migrant farmworkers

Studies have suggested that handgrip strength might be a marker for cardiometabolic risk (CMR), but it has not been studied in Hispanic/Latino farmworker population. This study aimed to characterize absolute and relative handgrip strength in Hispanic/Latino farmworkers, and investigate the sex-specific association between handgrip strength and CMR factors. CMR factors and seated isometric absolute (the sum of both hands) and relative (absolute handgrip strength divided by body mass index) handgrip strengths were collected in 173 Hispanic/Latino farmworkers (mean age 35.1 ± 0.7 years; 49% female). The absolute and the relative handgrip strengths were 89.2 ± 1.8 kg, 3.3 ± 0.1 kg among males, and 56.5 ± 1.9 kg, 1.9 ± 0.1 kg among females, respectively. Age was correlated with absolute (r = - 0.17, p = 0.03) and relative handgrip strengths (r = - 0.28, p < 0.01). In males, absolute handgrip was related to triglycerides (r = - 0.25, p < 0.05), whereas relative handgrip was related to waist circumference (r = - 0.32, p < 0.01), waist/hip circumference ratio (r = - 0.36, p < 0.01), high-density lipoprotein (r = 0.24, p < 0.05), and triglycerides (r = - 0.35, p < 0.01). In females, absolute handgrip was related to fasting plasma glucose (r = - 0.28, p = 0.03), whereas relative handgrip was related to waist circumference (r = - 0.38, p < 0.01) and fasting plasma glucose (r = - 0.22, p < 0.05). Males had lower absolute handgrip strength when their triglycerides levels were at risk (p = 0.021), and lower relative handgrip strength when their plasma glucose (p = 0.034) and triglycerides (p = 0.002) levels were at risk. Females had lower relative handgrip strength when their plasma glucose (p = 0.001) and blood pressure (p = 0.004) were at risk. This study suggests that handgrip strength may be associated with sex-specific CMR factors in a Hispanic/Latino farmworker population.

A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory

BACKGROUND

Measures of handgrip strength have not only emerged as a clinically viable screening tool for determining risk for morbidity, functional disability, and early mortality, but also for helping to identify cognitive deficits. However, the phenomena that links low handgrip strength with cognitive decline remains unclear. The role of the muscular and neural systems, and their adaptations to muscle strengthening activities over the life course, may provide important information for how age-related changes to muscle mass, strength, and neural capacity influence cognition. Moreover, disentangling how handgrip strength and cognitive function are associated may help to inform healthcare providers working with aging adults and guide targeted interventions aiming to preserve muscle and cognitive functioning.

OBJECTIVE

To 1) highlight and summarize evidence examining the associations of handgrip strength and cognitive functioning, and 2) provide directions for future research in this area.

METHODS

Articles from the PubMed database were searched from November 2018-May 2019. The search term algorithm, inclusion and exclusion criteria were pre-specified by investigators.

RESULTS

Several cross-sectional and longitudinal studies have revealed that measures of handgrip strength were associated with cognitive declines regardless of age demographics and the presence of comorbidities.

CONCLUSION

Handgrip strength can be used in clinical and epidemiological settings for helping to determine the onset and progression of cognitive impairment. Future research should continue to examine how handgrip strength and cognitive function are linked.

Associations between diabetes-related foot disease, diabetes, and age-related complications in older patients

PURPOSE

To examine the relationship of diabetes-related foot disease (DFD) with diabetes and age-related complications in older patients with diabetes mellitus (DM).

METHODS

We examined 562 outpatients with diabetes, aged ≥ 65 years, for DFD. The variables collected in this study were demographics, DM-related complications, treatment method, and age-related complications. Differences in the complications were compared between patients with and without DFD. Logistic regression analysis was used to determine the associations of DFD with DM and age-related complications.

RESULTS

A total of 246 patients (43.8%) had DFD. Logistic regression analysis identified low grip strength [Odds ratio (OR): 1.83, 95% confidence interval (CI) 1.21-2.76), hypertension (OR: 1.81, 95% CI 1.09-3.00), and diabetes-related peripheral neuropathy (DPN) (OR: 1.92, 95% CI 1.24-2.98) to be significantly associated with DFD. Patients with DPN and hypertension had a higher risk of DFD than patients with DPN or hypertension alone. Individuals with DPN and low grip strength (OR: 1.74, 95% CI 1.09-2.81) were at a lower risk than those with low grip strength alone.

CONCLUSION

Hypertension, DPN, and low grip strength were significantly associated with DFD in older patients with DM, with the risk of DFD being higher in patients with both DPN and hypertension. When considering DFD in older patients with DM, low grip strength should be considered equally important as a DM-related complication.

A Systematic Analysis of Temporal Trends in the Handgrip Strength of 2,216,320 Children and Adolescents Between 1967 and 2017

OBJECTIVE

To estimate national and international temporal trends in handgrip strength for children and adolescents, and to examine relationships between trends in handgrip strength and trends in health-related and sociodemographic indicators.

METHODS

Data were obtained through a systematic search of studies reporting temporal trends in the handgrip strength for apparently healthy 9-17-year-olds, and by examining large national fitness datasets. Temporal trends at the country-sex-age level were estimated by sample-weighted regression models relating the year of testing to mean handgrip strength. International and national trends were estimated by a post-stratified population-weighting procedure. Pearson's correlations quantified relationships between national trends in handgrip strength and national trends in health-related/sociodemographic indicators.

RESULTS

2,216,320 children and adolescents from 13 high-, 5 upper-middle-, and 1 low-income countries/special administrative regions between 1967 and 2017 collectively showed a moderate improvement of 19.4% (95% CI 18.4-20.4) or 3.8% per decade (95% CI 3.6-4.0). The international rate of improvement progressively increased over time, with more recent values (post-2000) close to two times larger than those from the 1960s/1970s. Improvements were larger for children (9-12 years) compared to adolescents (13-17 years), and similar for boys and girls. Trends differed between countries, with relationships between national trends in handgrip strength and national trends in health-related/sociodemographic indicators negligible-to-weak and not statistically significant.

CONCLUSIONS

There has been a substantial improvement in absolute handgrip strength for children and adolescents since 1967. There is a need for improved international surveillance of handgrip strength, especially in low- and middle-income countries, to more confidently determine true international trends.

PROSPERO REGISTRATION NUMBER

CRD42013003657.

Relations of Executive Function and Physical Performance in Middle Adulthood: A Prospective Investigation in African American and White Adults

OBJECTIVES

Previous studies in older adults found robust associations between executive functions (EF) and physical performance, as well as sociodemographic variation in physical performance decline. To examine these associations earlier in the adult lifespan, we investigated relations of EF, race, and sex with age-related physical performance decline during middle adulthood.

METHOD

Participants were 2,084 urban-dwelling adults (57.2% female; 57.8% African American; 37.3% living in poverty; mean baseline age = 48.1) from the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Mixed-effects regression was used to examine interactive relations among EF, race, sex, and age (indexing time) with change in dominant and nondominant handgrip strength and lower extremity strength over approximately 5 years. All analyses adjusted for poverty status, and subsequently adjusted for education, body mass index, hypertension, and diabetes.

RESULTS

There were no significant prospective associations between EF and decline in physical performance measures. Significant cross-sectional associations revealed that lower EF was associated with worse performance on all physical performance measures averaged across both time points (p < .05). A significant two-way interaction of Sex × Age (p = .019) revealed that men experienced greater age-related decline in lower extremity strength than women.

DISCUSSION

Findings did not reveal prospective associations between EF and physical performance decline in middle adulthood. However, they identified robust cross-sectional associations between EF and physical performance, and unexpectedly greater decline in lower extremity strength in men than women. Ultimately, these findings may inform prevention and intervention strategies targeting groups at risk for poorer physical function status and decline.

Temporal Trends in the Standing Broad Jump Performance of United States Children and Adolescents

Purpose: To estimate temporal trends in broad jump performance for United States youth, a marker of muscular fitness and health. Method: Electronic databases, topical systematic reviews, and personal libraries were systematically searched for studies reporting descriptive standing broad jump data for apparently healthy United States youth (age 10-17 years). Temporal trends at the sex-age level were estimated using sample-weighted regression models associating the year of testing to mean jump performance, with national trends standardized to the year 1985 using a post-stratified population-weighting procedure. Results: Collectively, there was a small increase of 12.6 cm (95%CI: 12.5 to 12.7) or 7.9% (95%CI: 7.1 to 8.6) in 65,527 United States youth between 1911 and 1990. Increases were greater for girls (change in means [95% CI]: 17.1 cm [16.9 to 17.3]; 11.4% [10.7 to 12.2]) compared to boys (change in means [95% CI]: 8.5 cm [8.3 to 8.7]; 4.6% [3.8 to 5.4]), but did not differ between children (10-12 years) and adolescents (13-17 years). Increases in broad jump performance were not always uniform across time, with steady and progressive increases observed for boys and children, respectively, and a diminishing rate of increase observed for girls and adolescents. Conclusions: Muscular fitness is a good marker of health, so greater broad jump performance from 1911 to 1990 may reflect corresponding changes in health. Routine assessment of broad jump performance may be useful to monitor trends in health and muscular fitness of United States youth due to its practicality, scalability, and predictive utility.

Association between the handgrip strength and the isokinetic muscle function of the elbow and the knee in asymptomatic adults

Background:

The handgrip strength is a practical, valid, reliable, low-cost tool that presents strong correlations with several health conditions. However, handgrip strength may be inaccurate to prospectively predict the variability of muscular function since the decrease in muscular strength over the years varies according to a muscular group or between upper and lower limbs. Our hypothesis is that the handgrip strength cannot explain the variance of muscle function prospectively.

Purpose:

The aim of this study was to evaluate the cross-sectional and prospective association between handgrip strength and isokinetic muscle function of the knee and elbow in 780 asymptomatic adults.

Methods:

In a sample of 780 adults, we obtained handgrip strength and elbow and knee muscle function (for both flexion and extension at 60°/s and 300°/s) using, respectively, a hydraulic dynamometer and an isokinetic dynamometer. In a cross-sectional analysis, we analyzed the data obtained from baseline assessment. Then, we calculated the absolute change as a result of the variation data between the baseline and the 1-year follow-up assessment of each participant. The correlations were analyzed using Pearson or Spearman coefficients. We used multivariate models to investigate the association between handgrip strength and isokinetic muscle function.

Results and Discussion:

The cross-sectional correlations were significantly moderate-to-strong (r = 0.41–0.71, p < 0.01), but became weak-to-moderate (r = 0.26–0.34, p < 0.01) prospectively. In the cross-sectional analysis, the handgrip strength was selected as a strong predictor for isokinetic variables (∆R² = 0.171–0.583, p < 0.05) as expected. Although handgrip strength was also selected as a significant predictor in prospective analysis, it explained only a little variance in isokinetic muscle function of the knee (∆R² = 0.7–0.117, p < 0.05). Regarding the predictive models for the elbow, handgrip strength was not selected prospectively.

Conclusion:

The 1-year absolute change of the handgrip strength cannot explain the variance of the isokinetic muscle function. Thus, specific measures are required for assessing muscle function in epidemiological studies.

A multidimensional functional fitness score has a stronger association with type 2 diabetes than obesity parameters in cross sectional data

Objectives

We examine here the association of multidimensional functional fitness with type 2 diabetes mellitus (T2DM) as compared to anthropometric indices of obesity such as body mass index (BMI) and waist to hip ratio (WHR) in a sample of Indian population.

Research design and method

We analysed retrospective data of 663 volunteer participants (285 males and 378 females between age 28 and 84), from an exercise clinic in which every participant was required to undergo a health related physical fitness (HRPF) assessment consisting of 15 different tasks examining 8 different aspects of functional fitness.

Results

The odds of being diabetic in the highest quartile of BMI were not significantly higher than that in the lowest quartile in either of the sexes. The odds of being a diabetic in the highest WHR quartile were significantly greater than the lowest quartile in females (OR = 4.54 (1.95, 10.61) as well as in males (OR = 3.81 (1.75, 8.3). In both sexes the odds of being a diabetic were significantly greater in the lowest quartile of HRPF score than the highest (males OR = 10.52 (4.21, 26.13); females OR = 10.50 (3.53, 31.35)). After removing confounding, the predictive power of HRPF was significantly greater than that of WHR. HRPF was negatively correlated with WHR, however for individuals that had contradicting HRPF and WHR based predictions, HRPF was the stronger predictor of T2DM.

Conclusion

The association of multidimensional functional fitness score with type 2 diabetes was significantly stronger than obesity parameters in a cross sectional self-selected sample from an Indian city.

The Prevalence of Metabolic Syndrome According to Grip Strength in Teenagers

The prevalence of metabolic syndrome in adolescents is increasing. Recently, the relevance of grip strength as a factor of metabolic syndrome in this population has raised questions. This study investigated the prevalence of metabolic syndrome according to grip strength in children and adolescents using large-scale data from the Korean National Health and Nutrition Survey (KNHNS). From 2014 to 2018, 1527 boys and 1292 girls participated in the KNHNS. The participants were classified into three groups according to age: 10-12 years (early teenager, ET), 13-15 years (middle teenager, MT), and 16-18 years (late teenager, LT). The participants were classified as having metabolic syndrome if they fulfilled three of the adolescent metabolic syndrome criteria. The grip strength was divided into groups with high and low grip strength, respectively, and the cutoff value for the prevalence was calculated using receiver operating characteristic curve analysis. There were significant differences in waist circumference, high-density lipoprotein cholesterol, and triglyceride levels based on grip strength in the ET, MT, and LT groups. Therefore, the prevalence of metabolic syndrome was lower when grip strength was higher. The cut-off values of the relative grip strength (kg/body weight) to predict metabolic syndrome among boys were 0.349, 0.466, and 0.485 for the ET, MT, and LT groups, respectively. The corresponding cut-off values for girls were 0.373, 0.383, and 0.382, respectively. In conclusion, there is a non-linear relationship between grip strength and metabolic syndrome in adolescents.

Serum uric acid is positively associated with muscle strength in older men and women: Findings from NHANES 1999-2002

BACKGROUND

One of the causes of strength loss in older adults is the increased oxidative stress; thus, substances with antioxidants properties may have protective effects on muscle strength. Uric acid (UA) is an important antioxidant and it seems to be positively associated with muscle strength in older adults; however, the current evidence is still limited.

AIM

To investigate whether serum UA is associated with muscle strength in older men and women.

METHODS

A cross-sectional study was performed evaluating older adults aged from 50 to 85 years from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2361 individuals (1256 men and 1105 women) were evaluated. The peak isokinetic knee extensor strength was assessed by kinetic communicator isokinetic dynamometer; while UA levels were measured by colorimetric method. Linear regression analyses were performed to estimate the coefficients and 95% confidence intervals for muscle strength by quintiles of UA levels, adjusted for potential confounders.

RESULTS

In the unadjusted analyses, serum UA was positively associated with peak force in men and total sample, but not in women. However, after adjustments for confounders, UA levels were positively associated with peak force in total sample (p-trend = 0.007), men (p-trend = 0.044) and women (p-trend = 0.016).

CONCLUSION

Serum UA is positively associated with muscle strength in older men and women. These results suggest that UA levels seem to be a protective factor for muscle strength in older adults independent of the sex.

Glucose regulation and grip strength in adults: Findings from the Helsinki Birth Cohort Study

AIM

This study aimed to assess the association between grip strength and glucose regulation in a cross-sectional setting.

METHODS

Using data from the Helsinki Birth Cohort Study, 924 men and 953 women were studied at a mean age of 61.6 years. Grip strength was assessed in the dominant hand using a Newtest Grip Force dynamometer. A standard 2-h 75 g oral glucose tolerance test (OGTT) was used to define glucose regulation. The participants were classified into four groups: normoglycaemia, prediabetes (impaired fasting glucose or impaired glucose tolerance), newly diagnosed diabetes and previously known diabetes. The association between grip strength and glucose regulation was assessed using multiple linear regression models.

RESULTS

Prediabetes was diagnosed in 32.2% and diabetes in 8.4% using the OGTT. A total of 7.8% of the individuals had previously known diabetes. Compared to individuals with normoglycaemia, grip strength was lower for those with newly diagnosed diabetes (-1.8 kg, 95% CI -3.2 to -0.5) as well as those with previously known diabetes (-1.8 kg, 95% CI -3.2 to -0.4) after adjusting for covariates (age, sex, body mass index, physical activity, education and smoking). No difference in grip strength was found when comparing those with prediabetes and normoglycaemia.

CONCLUSION

In adults, grip strength was lower among those with known and newly diagnosed diabetes compared to those with normoglycaemia. Together with previous findings on associations between grip strength and chronic diseases, these results support the use of grip strength as an overall health marker in adults.