Handgrip Strength and Current Smoking Are Associated with Cardiometabolic Risk in Korean Adolescents: A Population-Based Study

Weight-Specific Grip Strength as a Novel Indicator Associated With Cardiometabolic Risk in Children: The EMSNGS Study

CONTEXT

Handgrip strength (HGS) is an important indicator of sarcopenia and adverse health outcomes. However, evaluating HGS in children presents challenges, and its association with metabolism remains incompletely understood.

OBJECTIVE

To establish grip strength reference values for Chinese children and adolescents, as well as to evaluate the relationship between HGS and cardiometabolic risk.

METHODS

Data were collected from 4 072 participants aged 6-18 as part of the Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen (EMSNGS) study. HGS was measured, and relative HGS (RHGS) was normalized by body mass index. Age- or weight-specific HGS and RHGS were derived using the generalized additive model of location, scale, and shape model, and participants' values were categorized into quartiles, defining low strength as the lowest quartile. The cardiometabolic risk index (CMRI) z-score was calculated, with high risk defined as a z-score of ≥1.

RESULTS

Both boys and girls exhibited similar increases in age- and weight-specific grip strength. Low grip strength, classified by weight-specific HGS and RHGS, was linked to higher CMRI z-scores than classifications based on age-specific references in both sexes. A dose-dependent relationship was observed between weight-specific grip strength and cardiometabolic risk, particularly in boys. Compared with the middle category (P25th-P75th), the odds ratios for high cardiometabolic risks associated with low grip strength increased in both sexes.

CONCLUSION

This study established grip strength reference values for Chinese youth, introduced the concept of weight-specific HGS and RHGS, and demonstrated a dose-dependent relationship between weight-specific grip strength and cardiometabolic risk. These findings highlighted the association between low muscle strength and increased cardiometabolic risk.

Unsupervised identification of cardiometabolic profiles among adolescents: findings from the PARIS birth cohort study

Metabolic syndrome (MetS) is known as a risk factor in cardiometabolic morbidity but there is no consensus on its definition for teenagers. We aimed to identify cardiometabolic health profiles and which parameters best discriminate them. K-means partitioning identified cardiometabolic profiles by sex using data on health measurements of 530 adolescents from the PARIS birth cohort. A discriminant analysis was performed. Cardiometabolic risk score and handgrip strength were also measured. Depending on definitions, MetS prevalence ranged from 0.2% to 1.3%. Two profiles were identified for the entire group and by sex: "healthy" and "at cardiometabolic risk." Weight and waist-to-height ratio or waist circumference explained more than 87% of the variance in the profile differentiation. The "at cardiometabolic risk" profiles included adolescents with overweight, a waist-to-height ratio over 0.5, and prehypertension. They had higher cardiometabolic risk scores and parents who were more likely to be overweight and have cardiometabolic diseases themselves. They also had higher birthweights, earlier adiposity-rebound and puberty ages, and lower relative handgrip strength.  Conclusion: The two profiles identified, based on cardiometabolic health, were associated with early indicators and handgrip strength. Results suggest that the waist-to-height ratio is a useful clinical tool for screening individuals at cardiometabolic risk and who therefore require clinical follow-up. What is Known: • Although there is a need for tools to assess cardiometabolic health during adolescence, there is no consensus on the definition of metabolic syndrome for this age group. What is Knew: • The findings suggest that waist-to-height ratio can serve as a simple and valuable clinical tool for screening individuals at cardiometabolic risk who may require clinical monitoring for early prevention of cardiovascular diseases.

Handgrip Strength Is Associated with Metabolic Syndrome and Insulin Resistance in Children and Adolescents: Analysis of Korea National Health and Nutrition Examination Survey 2014-2018

Background

Reduced handgrip strength (HGS) is associated with adverse cardiometabolic health outcomes. We examined HGS, metabolic syndrome (MetS), and insulin resistance (IR) in children and adolescents.

Methods

The following population-based data from 2,797 participants (aged 10-18 years) of the Korea National Health and Nutrition Examination Survey 2014-2018 were analyzed: complete anthropometric measures, HGS, MetS, and IR (subgroup with fasting insulin, n=555). HGS was analyzed as the combined HGS (CHGS) and the normalized CHGS (nCHGS=CHGS divided by body weight).

Results

At a mean age of 14.4 years, 276 participants (9.9%) had abdominal obesity, 56 (2.0%) had MetS, and 118 (20.9%) had IR. Individual components of MetS and IR were inversely associated with the nCHGS. The odds ratios (ORs) for MetS and IR decreased significantly with higher nCHGS after adjustment for sex, age, physical activity, and sedentary times. The optimal cut-off values that predicted MetS were 0.80 kg/kg (males) and 0.71 kg/kg (females), with significant associations with MetS (OR: 7.4 in males; 5.7 in females) and IR (OR: 3.3 in males; 3.2 in females) observed when nCHGS values were lower than those cut-offs.

Conclusion

HGS is associated with MetS and IR and might be a useful indicator of cardiometabolic risk factors in children and adolescents.