Observational study: handgrip strength, body composition and diabetes mellitus.
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ABSTRACT: 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.
SUBMITTER: Suda N
PROVIDER: S-EPMC8399788 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:RATIONALE:Handgrip strength (HGS) predicts mortality in the elderly, but its determinants and clinical significance in chronic obstructive pulmonary disease (COPD) has not been defined. OBJECTIVES:We tested associations of HGS with pectoralis muscle area (PMA), subcutaneous adipose tissue (SAT), imaging characteristics, and lung function in smokers with COPD, and evaluated the cross-sectional and longitudinal associations of HGS with acute respiratory events. METHODS:We analyzed demographic, clinical, spirometry, HGS, and imaging data of 272 subjects with COPD, obtaining measures of airway thickness, emphysema, PMA, and SAT from chest computed tomography scans. We tested associations of lung function and imaging characteristics with HGS, using linear models. HGS association to acute respiratory events at enrollment and during follow-up (mean, 2.6 years) was analyzed using adjusted logistic models. RESULTS:HGS correlated with PMA, SAT, forced expiratory volume, and airway thickness, but not with body mass index or emphysema severity. In adjusted regression models, HGS was directly (β, 1.5; 95% confidence interval [CI], 0.1-3.0) and inversely (β, -3.3; 95% CI, -5.1 to -0.9) associated with one standard deviation of PMA and SAT, respectively, independent of body mass index and emphysema. In regression models adjusted for age, sex, body mass index, race, pack-years smoked, current smoking, chronic bronchitis, FEV1% predicted, emphysema, and airway metrics, HGS was associated with exacerbation risk; in cross-sectional analyses, there was an increment of 5% in the risk of exacerbations for each 1-kg decrement in HGS (risk ratio, 1.05; 95% CI, 1.01-1.08), and there was a similar risk during follow-up (risk ratio, 1.04; 95% CI, 1.01-1,07). CONCLUSIONS:In ever-smokers with COPD, HGS is associated with computed tomography markers of body composition and airway thickness, independent of body mass index and emphysema. Higher HGS is associated with lower exacerbation frequency.
| S-EPMC5711268 | biostudies-literature
Project description:BackgroundHandgrip strength (HGS) is associated with poor clinical outcomes, including all-cause, non-cardiovascular, and cardiovascular mortalities. The published cut-off points for HGS are mostly based on community populations from Western countries, lacking information on cancer patients from China. The objective of this study was to establish sex-specific cut-off points for Chinese cancer patients and investigate the effect of low HGS on cancer mortality.MethodsWe did a retrospective cohort study of patients who were diagnosed with malignant cancer from June 2012 to December 2018. HGS was measured using a hand dynamometer in 8257 cancer patients. Optimal stratification was used to solve threshold points. The hazard ratio (HR) of all cancer mortality and cancer-specific mortality was calculated using Cox proportional hazard regression models.ResultsAmong all participants, there were 3902 (47.3%) women and 4355 (52.7%) men. The median age was 58 years old. The cut-off points of HGS to best classify patients with respect to time to mortality were <16.1 kg for women and <22 kg for men. Low HGS was associated with overall cancer mortality in both women and men [HR = 1.339, 95% confidence interval (CI) = 1.170-1.531, P < 0.001; HR = 1.346, 95% CI = 1.176-1.540, P < 0.001, respectively]. For specific cancer types, low HGS was associated with breast cancer (HR = 1.593, 95% CI = 1.230-2.063, P < 0.001) in women, and lung cancer (HR = 1.369, 95% CI = 1.005-1.866, P = 0.047) and colorectal cancer (HR = 1.399, 95% CI = 1.007-1.944, P = 0.045) in men.ConclusionsOn the basis of our sex-specific cut-off points, low HGS was strongly associated with cancer mortalities. These results indicate the usefulness of HGS measurement in routine clinical practice for improving patient assessments, cancer prognosis, and intervention.
| S-EPMC7749566 | biostudies-literature
Project description:ObjectiveTo identify differences in amount and distribution of fat and lean soft tissue in a cross-sectional study of subjects with and without type 2 diabetes and to determine whether any differences are affected by race/ethnicity or sex.Design and methodsOverweight and obese (body mass index, BMI > or = 25 kg m(-2)) Black, White and Hispanic men (490) and women (825) with type 2 diabetes ((mean+/-s.d.) age 58.5+/-6.6; BMI 35.3+/-5.3) who had a baseline dual energy X-ray absorptiometry whole-body scan at the time of enrollment in the Look AHEAD clinical trial, and 242 healthy controls, 91 males and 151 females (age 55.3+/-8.6 years, BMI 30.7+/-4.2 kg m(-2)) who were participating in unrelated research and were scanned on the same densitometers.ResultsAdjusted for gender, age, race, clinical site and body size, total fat mass was smaller in persons with type 2 diabetes than in controls (-1.4+/-0.3 (s.e.); 34.5 vs 35.8 kg, P<0.001) while trunk fat was larger (1.3+/-0.2 (s.e.); 19.9 vs 18.6 kg, P<0.001) and leg fat was smaller (-1.5+/-0.2 (s.e.); 10.7 vs 12.3 kg, P<0.001). The arms of subjects with type 2 diabetes did not have significantly less fat compared to controls. Adjusted trunk lean mass was larger in type 2 diabetes by 0.6 kg (28.4 vs 27.8 kg, P<0.001) while leg lean was smaller by 0.5 kg (18.1 vs 18.6 kg, P<0.001).ConclusionsType 2 diabetes is associated with less total fat, leg fat and leg lean mass and more truncal fat and lean mass than controls. The physiological processes producing these deviations in tissue distribution and their metabolic significance warrant further investigation.
| S-EPMC2921819 | biostudies-literature
Project description:We investigated whether ethnic differences in handgrip strength, a marker of poor muscle strength and quality, is a potential cause of ethnic disparities in type 2 diabetes mellitus. We included 2086 Dutch, 2216 South Asian Surinamese, 2084 African Surinamese, 1786 Ghanaian, 2223 Turkish and 2199 Moroccan origin participants from the HELIUS study. We analyzed ethnic differences in handgrip strength, and its association with type 2 diabetes mellitus using logistic regression analyses adjusted for socio-demographic factors, body composition and lifestyle factors. Additionally, we investigated whether handgrip strength explained the ethnic differences in type 2 diabetes mellitus. We found that handgrip strength differed significantly across ethnic groups. After full adjustment, we found an inverse association with type 2 diabetes mellitus (OR 0.95; 95% CI 0.92-0.97) that did not differ substantially between ethnic groups, men and among women, and lean and overweight individuals. The association was not affected by the measure used to define type 2 diabetes mellitus, but was attenuated by exclusion of people with known diabetes. The ethnic differences in type 2 diabetes mellitus were not explained by handgrip strength (e.g. the OR for the South Asian Surinamese vs. Dutch changed from 5.03; 3.69-6.68 to 4.87; 3.57-6.65). In conclusion, we found large ethnic differences in handgrip strength and a consistent association of low handgrip strength with prevalent type 2 diabetes mellitus. This suggests that handgrip strength may be investigated as a target for intervention or a marker to identify people at risk of type 2 diabetes mellitus.
| S-EPMC4569584 | biostudies-literature
Project description:Knee extension strength (KES) improves following body mass-based lower body exercise training; however, it is unknown whether this type of exercise increases handgrip strength (HGS) as a result of a cross-education effect in older individuals. Our aim was to investigate the effect of a body mass-based exercise intervention on HGS and KES in older adults. At baseline, 166 subjects started a 12-week intervention program, and 160 (108 women and 52 men) subjects completed the study. A self-selected group of 37 older adults (21 women and 16 men) served as a control group. HGS, KES, and ultrasound-derived anterior thigh muscle thickness (anterior thigh MT) were measured at baseline and post-testing, and relative strength of the knee extensor (KES/anterior thigh MT) was calculated. A linear regression model controlling for baseline values of body-mass index, % body fat, fat-free mass, HGS, chair stand time, anterior thigh MT, and KES/body mass ratio found a significant difference between control and training groups for KES post-testing values (p = 0.001) and anterior thigh MT post-testing values (p = 0.012), but not for HGS post-testing values (p = 0.287). Our results suggest that increases in lower body strength and muscle size following a 12-week lower body mass-based exercise intervention fail to translate into improvements in HGS.
| S-EPMC5385419 | biostudies-literature
Project description:PurposeWe aimed to determine whether handgrip strength (HGS)improves type 2 diabetes (T2D) risk prediction beyond conventional risk factors.DesignHandgrip strength was assessed at baseline in 776 individuals aged 60-72 years without a history of T2D in a prospective cohort. Handgrip strength was normalized to account for the effect of body weight. Hazard ratios (HRs) (95% confidence intervals [CI]) and measures of risk discrimination for T2D and reclassification [net reclassification improvement (NRI), integrated discrimination index (IDI)] were assessed.ResultsDuring 18.1 years median follow-up, 59 T2D events were recorded. The HR (95% CI)for T2D adjusted for conventional risk factors was 0.49 (0.31-0.80) per 1 standard deviation higher normalised HGS and was 0.54 (0.31-0.95) and 0.53 (0.29-0.97) on adjustment for risk factors in the DESIR and KORA S4/F4 prediction models, respectively. Adding normalised HGS to these risk scores was associated with improved risk prediction as measured by differences in -2 log likelihood, NRI and IDI. Sex-specific HRs and risk prediction findings using sensitive measures suggested the overall results were driven by those in women.ConclusionAdding measurements of HGS to conventional risk factors might improve T2D risk assessment, especially in women. Further evaluation is needed in larger studies. KEY MESSAGES Handgrip strength (HGS) is independently associated with reduced risk of type 2 diabetes (T2D), but its utility in classifying or predicting T2D risk has not been explored. In this prospective cohort study of older Caucasian men and women, adding measurements of HGS to conventional risk factors improved T2D risk assessment, especially in women. Assessment of HGS is simple and inexpensive and could prove a valuable clinical tool in the early identification of people at high risk of future T2D.
| S-EPMC7877957 | biostudies-literature
Project description:ObjectiveIn this study, we employed a Mendelian randomization (MR) approach to investigate the independent causal associations of six body composition traits with gestational diabetes mellitus (GDM).MethodsGenome-wide significant levels (P < 10 × 5-8 ) of single nucleotide polymorphisms associated with body water mass, total protein, whole body fat-free mass, weight, whole body fat mass, and body fat percentage were used as instrumental variables. Data on GDM were obtained from the FinnGen Consortium, and both univariable and multivariable Mendelian randomization were performed. We utilized five different analytical methods including inverse-variance weighted (IVW), MR Egger, weighted median, simple mode, and weighted mode to assess the robustness of the results.ResultsWith univariable Mendelian randomization, the risk of GDM increased per 1-standard deviation (SD) increase in weight (ORweight = 1.297, P = 3.06 × 10-5 ), whole body fat mass (ORwhole body fat mass = 1.408, P = 1.32 × 10-6 ), and the risk of GDM increased per percent increase in body fat percentage (ORbody fat percentage = 1.661, P = 1.01 × 10-8 ). Total protein had a protective effect on the risk of GDM (ORtotal protein = 0.880, P = 0.048). However, there was no significant causal association between increases in body water mass and whole body fat-free mass per SD and the risk of GDM. Causal associations between weight, whole body fat mass, body fat percentage, and total protein with GDM were reduced to null in multivariable Mendelian randomization.ConclusionThe present study furnishes genetic evidence to elucidate the causal relationship between body composition traits and GDM. Additionally, further studies are imperative to establish a causal connection between body composition traits and gestational diabetes mellitus.
| S-EPMC10906022 | biostudies-literature
Project description:BackgroundThe age- and sex-related differences on the impacts of body composition on diabetes mellitus (DM) remain uncertain.MethodsThe fourth and fifth Korea National Health and Nutrition Examination Survey included 15,586 subjects over 30 years of age who completed dual-energy X-ray absorptiometry. We conducted a cross-sectional study to investigate whether muscle mass index (MMI), defined as appendicular skeletal muscle divided by body mass index (BMI), and fat mass index (FMI), defined as trunk fat mass divided by BMI, were differently associated with DM according to age and sex.ResultsIn multivariate logistic regression, the risk for DM significantly increased across quartiles of FMI in men aged ≥70. Meanwhile, MMI showed a protective association with DM in men of the same age. The odds ratios (ORs) for the highest quartile versus the lowest quartile of FMI and MMI were 3.116 (95% confidence interval [CI], 1.405 to 6.914) and 0.295 (95% CI, 0.157 to 0.554), respectively. In women, the ORs of DM was significantly different across FMI quartiles in those over age 50. The highest quartile of FMI exhibited increased ORs of DM in subjects aged 50 to 69 (OR, 1.891; 95% CI, 1.229 to 2.908) and ≥70 (OR, 2.275; 95% CI, 1.103 to 4.69) compared to lowest quartile. However, MMI was not significantly associated with DM in women of all age groups.ConclusionBoth FMI and MMI were independent risk factors for DM in men aged 70 years or more. In women over 50 years, FMI was independently associated with DM. There was no significant association between MMI and DM in women.
| S-EPMC8024156 | biostudies-literature
Project description:ObjectivesRecent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults.MethodsThis study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry.ResultsIn total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS.ConclusionsDepression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.
| S-EPMC7939759 | biostudies-literature
Project description:ObjectiveTo compare the effect of Whole-Body Vibration Exercise (WBVE) applied in push-up modified and half-squat positions, on handgrip strength (HS) and on the electromyography registry (EMGrms) of the flexor digitorum superficialis muscle (FDSM) of the dominant hand.MethodsNineteen healthy women (age 23.40 ± 4.03 years, bodyweight: 58.89 ± 9.87 kg), performed in a randomized order five different tests: (S1) Control; (S2) Push-up modified; (S3) Push-up placebo; (S4); Half-squatting; (S5) Half-squatting placebo. The HS and the EMGrms were assessed at baseline and immediately after the tests. ANOVA two-way design mixed test, with Tukey post hoc, was used to evaluate the HS, EMGrms and the ratio between EMGrms and HS, i.e., neural ratio (NR). Thus, the lower NR represents the greater neuromuscular modifications. The statistical significance level was set up at p < 0.05.ResultsWBVE on S2 increased HS compared to the stimulus applied to the S4 (p = 0.0001). The increase in HS was associated with a reduction in the EMGrms of the FDSM (p < 0.001) and a lower NR (p < 0.0001), i.e., greater neuromuscular modifications, in the S2 compared to the S4 after the tests.ConclusionThe distance of the stimulus and the positioning on the vibratory platform influence the maximum muscular strength due to neuromuscular modifications of hands in healthy women.
| S-EPMC7848817 | biostudies-literature