Hand Grip Strength Relative to Waist Circumference as a Means to Identify Men and Women Possessing Intact Mobility in a Cohort of Older Adults with Type 2 Diabetes

Dietary and lifestyle determinants of vitamin D status in the UK Biobank Cohort study for predictive modeling

BACKGROUND

Vitamin D (VD) is involved in a wide variety of physiological processes. The high prevalence of VD deficiency in the population requires stronger preventive measures.

OBJECTIVE

Characterize the dietary and lifestyle determinants of VD levels in blood and of VD deficiency to further develop predictive models of these two outcomes.

METHODS

63,759 participants from the UK Biobank study with available data on dietary intake of VD, assessed via 24-hour recalls, and with measurements of serum 25(OH)D levels. Linear and logistic regression models were applied to identify factors associated with VD levels and VD deficiency outcomes, and to evaluate the influence of covariates on the association between VD in serum and VD in the diet. Predictive models were constructed using classical regression models and machine learning methods based on penalized likelihood methods.

RESULTS

Approximately 10% of the participants had VD deficiency (VD < 25 nmol/L), and 38.9% were at risk of VD inadequacy (VD 25-49 nmol/L). The dietary intake of VD was significantly lower in the VD deficient group. This latter group showed lower engagement in physical activity (22.1%) compared to the non-deficient group (13.4%; p < 0.001). Also, overweight and obesity (vs normal weight) were related to a greater likelihood of VD deficiency (OR = 1.18 and 1.96, respectively). A similar odds of VD deficiency was observed for abdominal obesity (OR = 1.83). A weaker association was observed between dietary VD intake, based on participant reports, and VD levels. With regard to sunlight exposure, darker skin tones (OR dark vs fair skin = 3.11), season (OR winter vs autumn = 3.76) and less outdoor time activities (OR per 1 hour increase = 0.96) were also related to VD deficiency. Predictive models for both classical regression and machine learning, showed good accuracy (AUC = 0.8-0.9 for VD deficiency).

CONCLUSIONS

While a rich diet in VD boosts its levels, sun exposure plays a more significant role particularly in populations from the UK or Northern Europe. A predictive model including key determinants could effectively assess VD deficiency.

Association of relative hand grip strength with myocardial infarction and angina pectoris in the Korean population: a large-scale cross-sectional study

BACKGROUND

Low hand grip strength (HGS) is associated with the risk of cardiovascular diseases, but the association between HGS and myocardial infarction/angina pectoris (MIAP) is unclear. Furthermore, there have been no studies examining the associations of MIAP with anthropometric indices, absolute HGS indices, and relative HGS indices calculated by dividing absolute HGS values by body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), or weight values. Therefore, the objective of this study was to examine the associations of MIAP with absolute and relative HGS combined with several anthropometric indices.

METHODS

In this large-scale cross-sectional study, a total of 12,963 subjects from the National Health and Nutrition Examination Survey were included. Odds ratios and 95% confidence intervals for the associations of MIAP with anthropometric indices, absolute HGS indices, and relative HGS indices were computed from binary logistic regression models. We built 3 models: a crude model, a model that was adjusted for age (Model 1), and a model that was adjusted for other relevant covariates (Model 2).

RESULTS

For men, the average age was 61.55 ± 0.16 years in the MIAP group and 66.49 ± 0.61 years in the non-MIAP group. For women, the average age was 61.99 ± 0.14 years in the MIAP group and 70.48 ± 0.61 years in the non-MIAP group. For both sexes, the MIAP group had lower diastolic blood pressure, shorter stature, greater WC, and a greater WHtR than did the non-MIAP group, and women tended to have greater systolic blood pressure, weight, and BMI than in men. HGS was strongly associated with the risk of MIAP in the Korean population. In men, relative HGS indices combined with WC and the WHtR had greater associations with MIAP than did the anthropometric indices and absolute HGS indices. However, in women, anthropometric indices, including weight, BMI, WC, and WHtR, were more strongly associated with MIAP than were absolute and relative HGS indices, unlike in men. When comparing absolute and relative HGS indices in women, relative HGS indices combined with BMI and weight was more strongly related to MIAP than was absolute HGS indices.

CONCLUSIONS

MIAP might be better identified by relative HGS than absolute HGS in both sexes. The overall magnitudes of the associations of MIAP with absolute and relative HGS are greater in men than in women.