Handgrip strength predicts new prediabetes cases among adults: A prospective cohort study

Weakness Status is Differentially Associated with Time to Diabetes in Americans

Background

The purpose of this study was to evaluate the associations of (1) individual absolute and body size normalized weakness cut-points, and (2) the collective weakness classifications on time to diabetes in Americans.

Methods

We analyzed data from 9577 adults aged at least 50-years from the Health and Retirement Study. Diabetes diagnosis was self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males with HGS <35.5 kg (absolute), <0.45 kg/kg (normalized to body weight), or <1.05 kg/kg/m2 (normalized to BMI) were categorized as weak. Females were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg/kg/m2. Compounding weakness included falling below 1, 2, or all 3 cut-points.

Results

Persons below the body weight normalized weakness cut-points had a 1.29 (95% confidence interval (CI): 1.15-1.47) higher hazard for incident diabetes, while those below the BMI normalized cut-points had a 1.30 (CI: 1.13-1.51) higher hazard. The association between absolute weakness and incident diabetes was insignificant (hazard ratio: 1.06; CI: 0.91-1.24). Americans below 1, 2, or all 3 collective weakness categories had a 1.28 (CI: 1.10-1.50), 1.29 (CI: 1.08-1.52), and 1.33 (CI: 1.09-1.63) higher hazard for the incidence of diabetes, respectively.

Conclusions

Our findings indicate that while absolute weakness, which is confounded by body size, was not associated with time to diabetes, adjusting for the influence of body size by normalizing HGS to body weight and BMI was significantly associated with time to diabetes. This suggests that muscle strength, not body size, may be driving such associations with time to diabetes.

Clinical outcomes of multidimensional association of type 2 diabetes mellitus, COVID-19 and sarcopenia: an algorithm and scoping systematic evaluation

BACKGROUND

The aim of this study was to provide a scoping and comprehensive review for the clinical outcomes from the cross-link of Type 2 diabetes mellitus (T2DM), COVID-19, and sarcopenia.

METHODS

By using PRISMA guidelines and searching through different databases that could provide findings of evidence on the association of T2DM, COVID-19, and sarcopenia.

RESULTS

Thirty-three studies reported a relationship between sarcopenia with T2DM, twenty-one studies reported the prognosis COVID-19 in patients with T2DM, ten studies reported the prognosis of COVID-19 in patients with sarcopenia, five studies discussed the outcomes of sarcopenia in patients with COVID-19, and one study reported sarcopenia outcomes in the presence of T2DM and COVID-19.

CONCLUSION

There is an obvious multidimensional relationship between T2DM, COVID-19 and sarcopenia which can cause prejudicial effects, poor prognosis, prolonged hospitalisation, lowered quality of life and a higher mortality rate during the current COVID-19 pandemic.

Handgrip strength of young athletes differs based on the type of sport played and age

OBJECTIVE

Handgrip strength may differ depending on the type of sport played during the developmental period. Youth sports in which athletes hold equipment in their hands may be the most effective for improving handgrip strength. This study aimed to examine the age at which differences in handgrip strength appear by comparing sports that involve gripping (kendo) with those that do not involve gripping (soccer) in young athletes.

METHODS

Two hundred and twenty-two male athletes (115 kendo and 107 soccer) between 6 and 15 years old participated in this study. Handgrip strength was measured using a dynamometer, and the average value of both hands was used for analysis. Sports experience was determined when they started practicing each sport. Handgrip strength was compared between sports. Statistical moderation was used to determine if the relationship between sport and handgrip strength depended upon the age of the athlete.

RESULTS

Kendo athletes had significantly higher handgrip strength than soccer athletes (4.77 kg [95% CI: 2.34, 7.19]) in the overall sample. We found that the relationship between sport and handgrip strength depended upon the age of the child (sport*age t = -3.6, p = .004). Using the Johnson-Neyman procedure, we found statistically significant differences between sports from 8.48 years and older.

CONCLUSIONS

Our results suggest that the type of sport played, that is, whether or not an athlete plays with sports equipment in their hands, may influence the development of handgrip strength during the period of growth, and these sports may contribute to a higher level of handgrip strength in adulthood.

Exercise-induced microbial changes in preventing type 2 diabetes

The metabolic benefits associated with long-term physical activity are well appreciated and growing evidence suggests that it involves the gut microbiota. Here we re-evaluated the link between exercise-induced microbial changes and those associated with prediabetes and diabetes. We found that the relative abundances of substantial amounts of diabetes-associated metagenomic species associated negatively with physical fitness in a Chinese athlete students cohort. We additionally showed that those microbial changes correlated more with handgrip strength, a simple but valuable biomarker suggestive of the diabetes states, than maximum oxygen intake, one of the key surrogates for endurance training. Moreover, the causal relationships among exercise, risks for diabetes, and gut microbiota were explored based on mediation analysis. We propose that the protective roles of exercise against type 2 diabetes are mediated, at least partly, by the gut microbiota.

Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study

(1) Background: Diabetes mellitus (DM) is a well-known disease that causes comorbidities such as chronic kidney disease (CKD) and cardiovascular disease. Therefore, it is necessary to develop diagnostic tools to prevent DM. Handgrip strength, a known diagnostic tool for sarcopenia, is a predictor of several diseases. However, the value of handgrip strength as an indicator of incident DM in Asian populations remains unknown. This study aimed to identify the relationship between handgrip strength and incidence of DM in Korean adults according to sex. (2) Methods: A total of 173,195 participants registered in a nationwide cohort were included in this study. After applying the exclusion criteria, 33,326 participants remained. DM occurred in 1473 individuals during the follow-up period (mean follow-up period, 4.1 years). To reduce the impact of body size, the study population was subdivided into quartiles of relative handgrip strength, defined as absolute handgrip strength divided by body mass index. Multivariate Cox regression analysis revealed that the relative handgrip strength was inversely associated with new-onset DM. (3) Results: Compared with the lowest quartile (Q1), the hazard ratios (HRs) [95% confidence intervals (CIs)] for new-onset DM for the highest quartiles (Q4) was 0.60 (0.43-0.84) in men and 0.72 (0.52-0.99) in women after adjusting for confounding factors. The incidence of DM decreased with the increase in the relative handgrip strength. These inverse relationships were statistically more significant in men than in women. (4) Conclusions: This novel study revealed that relative handgrip strength is related to incident DM in both men and women. Relative handgrip strength can be used as a practical tool to prevent DM. Regular measurement of handgrip strength can be used to detect DM.

Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus

Purpose

To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care.

Patients and Methods

The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis.

Results

The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (β = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001).

Conclusion

WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.

Prediabetes is associated with loss of appendicular skeletal muscle mass and sarcopenia

Background

Decreasing mass and metabolism in skeletal muscle are associated with increasing insulin resistance (IR) and type 2 diabetes mellitus (T2DM). The causal relation between sarcopenia and abnormal glucose metabolism may be bidirectional. This investigation is aimed to explore the detailed correlation between pre-diabetes and sarcopenia in United States (US) adults.

Methods

A total of 22,482 adults aged ≥20 years in the National Health and Nutrition Examination Survey (NHANES) were included. Generalized linear models were conducted to examine associations between diabetes status, serum glucose, glycohemoglobin (HbA1c), and sarcopenia. Generalized additive models and smooth fitting curves were used to examine the non-linear relationship between HbA1c and ASM_BMI. Sarcopenia was defined as ASM_BMI (appendicular skeletal muscle mass/body mass index) < 0.789 for males, and <0.512 for females based on the cut-off values of the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project.

Results

After fully adjusting for multiple covariates, sarcopenia was directly correlated with pre-diabetes [OR (95%CI) = 1.230 (1.057, 1.431), p = 0.008] and T2DM [OR (95%CI) = 2.106 (1.625, 2.729), p < 0.001]. In non-T2DM population, HbA1c was negatively correlated with ASM_BMI [β (95%CI) = -0.009 (-0.013, -0.005), p < 0.001]. The correlations only persisted in males. Furthermore, in male non-T2DM population, the association of HbA1c and ASM_BMI presents an inverted U-shape curve with an inflection point of HbA1c 5.2%.

Conclusion

Pre-diabetes is associated with increased risk of sarcopenia. HbA1c is an independent risk factor for loss of appendicular skeletal muscle mass and sarcopenia when HbA1c greater than 5.2% in the male non-T2DM population.

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.

Muscle strength and prediabetes progression and regression in middle-aged and older adults: a prospective cohort study

BACKGROUND

Prediabetes progression is associated with increased mortality while its regression decreases it. It is unclear whether muscle strength is related to prediabetes progression or regression. This study investigated the associations of muscle strength, assessed by grip strength and chair-rising time, with prediabetes progression and regression based on the China Health and Retirement Longitudinal Study (CHARLS) enrolling middle-aged and older adults.

METHODS

We included 2623 participants with prediabetes from CHARLS, who were followed up 4 years later with blood samples collected for measuring fasting plasma glucose and haemoglobin A1c. Grip strength (normalized by body weight) and chair-rising time were assessed at baseline and categorized into tertiles (low, middle, and high groups). Prediabetes at baseline and follow-up was defined primarily using the American Diabetes Association (ADA) criteria and secondarily using the World Health Organization (WHO) and International Expert Committee (IEC) criteria. Multinomial logistic regression analysis was applied to obtain the odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The mean age of included participants was 59.0 ± 8.6 years, and 46.6% of them were males. During follow-up, 1646 participants remained as prediabetes, 379 progressed to diabetes, and 598 regressed to normoglycaemia based on ADA criteria. Participants who progressed to diabetes had lower normalized grip strength than those who remained as prediabetes (0.49 ± 0.15 vs. 0.53 ± 0.15, P < 0.001), but participants who regressed to normoglycaemia showed the opposite (0.55 ± 0.16 vs. 0.53 ± 0.15, P = 0.003). However, chair-rising time was comparable across different groups (P_overall  = 0.17). Compared with participants in low normalized grip strength or high chair-rising time group, those in high normalized grip strength or low chair-rising time group had decreased odds of progression to diabetes (OR 0.62, 95% CI 0.44 to 0.87; and OR 0.69, 95% CI 0.51 to 0.93, respectively) after multivariable adjustment. However, both were unrelated to the odds of regression to normoglycaemia (OR 0.94, 95% CI 0.71 to 1.25; and OR 0.84, 95% CI 0.65 to 1.07, respectively). These outcomes remained generally comparable when prediabetes was defined by WHO or IEC criteria. Higher normalized grip strength but not lower chair-rising time was prospectively associated with lower blood pressure, better glycaemic condition, and lower inflammation (all P ≤ 0.04).

CONCLUSIONS

High muscle strength is associated with reduced odds of progression to diabetes but does not predict regression to normoglycaemia in prediabetes. Future studies are warranted to assess whether increases in muscle strength promote prediabetes regression.

Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population

BACKGROUND

handgrip strength (HGS) is a health-status parameter associated with multicomorbidity in the adult population.

OBJECTIVE

the aim of the present study was to determine the association between HGS (i.e., absolute and relative) and abdominal obesity (AO), type-2 diabetes (T2D), and hypertension (HT), as well as to determine the association between low relative HGS with the presence of multicomorbidity (i.e., the co-occurrence of two or more comorbidities together) in a Mexican population.

METHODOLOGY

a cross-sectional study was carried out in 860 participants from the south of Mexico (661 women and 199 men). The age range evaluated was from 18 to 65 years. Assessments were made of sociodemographic data, clinical history, anthropometric parameters, and measurement of maximal HGS.

RESULTS

the regression models adjusted by age show that the presence of comorbidities (i.e., AO, HT and T2D) was linked negatively to HGS (i.e., absolute and relative). Moreover, in men, a low relative HGS in both hands reported an association with the presence of three simultaneous comorbidities (right, RR: 17.2, p < 0.001; left, RR: 11.92, p = 0.020). In women the same association was found (right, RR: 10.42, p < 0.001; left, RR: 9.90, p < 0.001).

CONCLUSION

lower levels of relative HGS were linked to the presence of simultaneous comorbidities (i.e., the joint presence of AO, T2D and HT). Furthermore, HGS (i.e., absolute and relative) presented an inverse association with individual anthropometric and clinical parameters related to cardiovascular risk in the Mexican population.

Association between Oral Health Status and Relative Handgrip Strength in 11,337 Korean

Grip strength is a simple indicator of physical strength and is closely associated with systemic health. Conversely, oral health has also been reported to have an important association with systemic health. The present study aimed to assess the effect of oral health status on relative handgrip strength. The data pertaining to 11,337 participants were obtained by means of the seventh Korea National Health and Nutrition Survey (2016 to 2018). Oral health status was evaluated on the basis of the presence of periodontitis and number of remaining teeth (PT, present teeth). Relative handgrip strength was evaluated by means of a digital dynamometer and the value pertaining to the lower 25% of measurements was used as the quartile by gender. The association between oral health status and relative handgrip strength was evaluated by means of multiple regression analysis and multiple logistic regression analysis with covariate correction. Analysis of the crude model revealed a significant association in the group of patients with periodontal disease (odds ratio = 1.69, 95% confidence interval: 1.51-1.89). However, analysis with adjusted covariates revealed that the association was not statistically significant. Moreover, statistical analysis after adjustment for covariates revealed a consistent correlation between PT and relative handgrip strength as categorical and continuous variables. Hence, the present study observed a significant association between oral health status and relative handgrip strength among the Korean adult population.

Handgrip strength as a simple measure for screening prediabetes and type 2 diabetes mellitus risk among adults in Malawi: A cross-sectional study

OBJECTIVE

Handgrip strength, a simple measure of muscle strength, has been reported as a predictor of both prediabetes and type 2 diabetes mellitus (T2DM) and has been suggested for screening prediabetes and T2DM risk. This study examined the relationship of handgrip strength with prediabetes and T2DM among rural- and urban-dwelling adults in Malawi.

METHODS

This was a cross-sectional study nested in a follow-up study of prediabetic and prehypertensive individuals identified during an extensive noncommunicable disease survey in Malawi. A total of 261 participants (women: 64%) were recruited. Univariate and multivariate binary logistic regression analyses were performed to examine the association of prediabetes and T2DM with relative handgrip strength.

RESULTS

The mean (SD) age of the participants was 49.7 (13.6) years, and 54.0% were between the ages of 40 and 59 years. The mean (SD) absolute handgrip strength and relative handgrip strength were 28.8 (7.3) kg and 1.16 (0.40) kg/BMI, respectively, and the mean relative handgrip strength differed significantly (p < 0.001) by T2DM status. In unadjusted model, the odds ratio (OR) of prediabetes and T2DM per unit increase in relative handgrip strength was 0.12 [95% CI; 0.04-0.33]. The result remained significant after adjusting for age (continuous), sex, place of study, hypertension, dyslipidaemia and level of education (aOR [95% CI]; 0.19 [0.03-0.95]).

CONCLUSIONS

The findings suggest that handgrip strength could be a relatively inexpensive, noninvasive measure for contributing to risk scores to identify high-risk individuals for screening diabetes in SSA.

What can hand grip strength tell us about type 2 diabetes?: mortality, morbidities and risk of diabetes

INTRODUCTION

Hand grip strength (HGS) has been determined as a simple and cost effective method for evaluating overall skeletal muscle strength and quality. It has been used in numerous clinical studies to examine the association between skeletal muscle and type 2 diabetes (T2D). Previous studies have shown that HGS is significantly associated with mortality and cardiovascular disease (CVD) in patients with T2D. As the prevalence of T2D has seen a steady increase globally, HGS measurement can be useful and essential in managing T2D.

AREAS COVERED

This narrative review summarizes the current evidence regarding the association between HGS and T2D. HGS has been considered a useful tool for identifying risks for T2D, CVD, and mortality and evaluating skeletal muscle strength and quality.

OPINION

HGS should be measured in all patients with T2D together with height, weight, and waist circumference. However, there is yet no standard method used in measuring for HGS. T2D patients with a low HGS can engage in resistance training more effectively with appropriate advice based on HGS. Future studies clarifying the genetic association between skeletal muscle and T2D are needed to provide individualized exercise therapy.

Observational study: handgrip strength, body composition and diabetes mellitus

Objective

Previous studies have shown that relative handgrip strength, handgrip measure divided by body mass index (BMI), affects the future onset of diabetes and prediabetes. However, fat free mass (FFM) has been suggested to adjust for this effect better than BMI. In this study, we examined applicability of models that adjusted handgrip-diabetes relationship with either BMI or FFM.

Results

Of 1940 participants (56.2% male, average (SD) age, 57.2 [11.2] years), 267 (13.8%) had diabetes (DM) and 912 (47.0%) had prediabetes (pre-DM). The average handgrip measure for men was 40.0 kg (tertile measures, 37.4 kg and 42.5 kg) and for women 24.2 kg (tertile measures, 22.6 kg and 25.7 kg). Among both sexes, the percentage of people unaffected by DM or pre-DM was highest in the strong handgrip group and lowest in the weak handgrip group. Analysis using binary logistic models showed that an increase in handgrip measure was associated with a decrease in the chance of having either pre-DM or DM. This effect was detected by both BMI models and FFM models, even after adjustment for medical and lifestyle factors. Either or both should be used depending on the research aims, setting and methods.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05731-4.

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.

Association between relative handgrip strength and prediabetes among South Korean adults

BACKGROUND

Diabetes is a progressive disease, and thus, it is important to prevent diabetes at the prediabetes stage. Although the loss of muscle strength and prediabetes are associated, few studies have examined relative handgrip strength (RHGS), which can be an indicator of both muscle strength and adiposity. Therefore, our study aimed to examine the association between RHGS and prediabetes (HbA1c level >5.7%) stratified by sex due to sex differences in strength.

METHODS

We analyzed data from the 2016-2018 Korean National Health and Nutrition Examination Survey. Prediabetes was defined using the HbA1c cut-off level of 5.7-6.4%, identified by the American Diabetes Association. RHGS was calculated as the maximal absolute handgrip strength of both hands divided by body mass index and was divided into sex-specific quartiles. Multiple logistic regression analysis was performed to determine the association between sex-specific RHGS and prediabetes.

RESULTS

Among the total participants, 13,384 did not have diabetes. In men, the low and mid-low RHGS groups had increased odds of prediabetes (low group, odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.10-1.82; mid-low group, OR: 1.32, 95% CI: 1.04-1.67). However, no significant differences were observed between the corresponding female groups. Moreover, central obesity and lower RHGS were strongly associated with prediabetes in men (low group, OR: 2.40, 95% CI: 1.52-3.80; mid-low group, OR: 2.00, 95% CI: 1.26-3.17; mid-high group, OR: 1.76, 95% CI: 1.11-2.81), and a trend was observed (p = 0.0026).

CONCLUSION

RHGS could be a practical and inexpensive tool for predicting diabetes in men. Programs aimed at preventing diabetes need to include exercise routines for improving muscle strength, and further research through longitudinal studies is required to investigate the causality of RHGS on the risk of prediabetes.

Prevalence of Metabolic Syndrome and Association with Grip Strength in Older Adults: Findings from the HOPE Study

OBJECTIVE

To determine the prevalence of metabolic syndrome (MetS) in older adults and assess the association of MetS and adverse outcomes with handgrip strength (HGS), HGS/body weight (BWT), and HGS/body mass index (BMI).

METHODS

A cross-sectional population study in Singapore. Data were collected on demographics, HGS, Timed-Up and Go (TUG), fasting glucose, lipid profile, blood pressure, waist circumference, frailty status, and cognition in 722 older adults ≥65 years old. MetS was defined using the Modified ATP III for Asians where at least three of the following conditions must be fulfilled, central obesity, high blood glucose (or diagnosed diabetes mellitus), high blood pressure (or diagnosed hypertension), low high-density lipoprotein, and high triglycerides. The waist circumference in the Modified ATP III for Asians is ≥90 cm for males or ≥80 cm for females. HGS and HGS normalized by BWT or BMI were used for the association.

RESULTS

The prevalence of MetS in older adults was 41.0%, and those ≥85 years old 50.0%. The prevalence was higher in females ≥70 years old, with 8 in 10 females ≥85 years having MetS. After adjusting for age, years of education, physical exercise, as well as history of smoking and alcohol consumption, higher HGS normalized by BWT or BMI was significantly associated with lower odds of having MetS (OR: 0.51,95% CI 0.43-0.61, p<0.01) and (OR: 0.13, 95% CI 0.07-0.24, p<0.01).

CONCLUSION

Almost 1 in 2 older adults had MetS, with the prevalence in females much higher than that in males over 70 years old. Our findings suggest that both HGS/BWT and HGS/BMI had a significant negative association with MetS, its components, and adverse effects. Further studies are needed to validate the association and to determine optimal cutoffs of HGS/BWT and HGS/BMI for MetS, and the effectiveness of interventions in averting the risk.