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Alkahtani SA, Alshammari GM, Alzuwaydi A, Alfuhaid A, Al-Masri AA, Qaisar R, Habib SS. Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations. Aging Male 2024; 27:2325146. [PMID: 38468373 DOI: 10.1080/13685538.2024.2325146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
AIM This cross-sectional study investigated the association between metabolic syndrome (MetS) and handgrip strength (HGS) with respect to sex and adiposity in Saudi men (n = 287) and women (n = 268). MATERIAL AND METHODS Anthropometry, body composition, HGS, and blood biochemistry were measured. The average age of the study population was 57.65 ± 9.3 years (men = 55.1 ± 9.3 years, women = 60.4 ± 9.3 years). We report that HGS/body mass index (BMI), HGS/weight, and HGS/fat (%) were significantly higher in controls than in patients with MetS in men but not in women. According to the ROC analysis, relative HGS (RHGS) was higher than HGS alone in the association with MetS, which was significant for men (p < 0.01). At lower quartiles of HGS, the probability of MetS was higher in women, and the same was found in men in the lower quartiles of HGS/%Fat. Multinomial regression revealed significant associations between age and adiposity and MetS in men and HGS in women. Additionally, the linear regression of age, HGS, and weight exhibited significant associations between HGS with WC in both sexes. CONCLUSION A higher risk of MetS in the lower quartiles of HGS was found in women, and adiposity moderated the relationship between HGS and MetS in men.
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Affiliation(s)
- Shaea A Alkahtani
- Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Ghedeir M Alshammari
- Department of Nutrition, College of Agriculture and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Aishah Alzuwaydi
- Department of Nutrition, College of Agriculture and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alfuhaid
- Exercise Physiology Department, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Abeer A Al-Masri
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab of Emirates
| | - Syed Shahid Habib
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Qi KJ, Li Q, Lu GL, Zhang MJ, Zhang MZ, Yan JM, He QQ. The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study. Arch Gerontol Geriatr 2024; 124:105481. [PMID: 38733920 DOI: 10.1016/j.archger.2024.105481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the combined effect of handgrip strength (HGS) and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly people. METHODS The data was used from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults who participated in surveys between 2011 and 2018 were included in the study. They were divided into 4 different types of obesity phenotypes based on obesity and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically abnormal non-overweight/obesity (MANO), and metabolically abnormal overweight/obesity (MAO). The HGS level was divided into low and high groups according to the median values. Cox proportional risk regression model was used to analyze the joint effect of HGS and obesity phenotype on the risk of stroke among participants. RESULTS A total of 7904 participants aged 58.89±9.08 years were included in this study. After adjusting for potential confounders, high HGS&MHO (HR=1.86, 95 % CI=1.12-3.09), high HGS&MANO (HR=2.01, 95 %CI=1.42-2.86), high HGS&MAO (HR=2.01, 95 % CI=1.37-2.93), low HGS&MHNO (HR=1.57, 95 % CI=1.00-2.46), low HGS&MHO (HR=2.09, 95 % CI=1.29-3.38), low HGS&MANO (HR=2.02, 95 % CI=1.35-3.03), and low HGS&MAO (HR=2.48, 95 % CI=1.72-3.58) group had significantly higher risks of stroke than the high HGS&MHNO group. CONCLUSION The coexistence of metabolically unhealthy and low HGS can synergistically increase the risk of stroke in Chinese middle-aged and elderly people.
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Affiliation(s)
- Kai-Jie Qi
- School of public health, Wuhan University, Wuhan, China
| | - Qiang Li
- School of health and nursing, Wuchang University of Technology, Wuhan, China
| | - Gao-Lei Lu
- School of public health, Wuhan University, Wuhan, China
| | - Min-Jie Zhang
- School of public health, Wuhan University, Wuhan, China
| | - Min-Zhe Zhang
- School of public health, Wuhan University, Wuhan, China
| | - Jia-Min Yan
- Department of Laboratory Medicine, Wuhan Children's Hospital, Wuhan, China.
| | - Qi-Qiang He
- School of public health, Wuhan University, Wuhan, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, China.
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Mirrafiei A, Radkhah P, Chambari M, Davarzani S, Babaee N, Djafarian K, Shab-Bidar S. Higher dietary methyl donor micronutrient consumption is associated with higher muscle strength in adults: a cross-sectional study. Br J Nutr 2024; 131:1926-1933. [PMID: 38443195 DOI: 10.1017/s0007114524000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Methyl donor micronutrients might affect muscle strength via DNA methylation. We aimed to evaluate the combined relationship of dietary methyl donor micronutrients containing betaine, choline, methionine, vitamin B12, vitamin B6 and folate on muscle strength. This cross-sectional study was conducted on 267 subjects including 113 men and 154 women. Dietary intake of micronutrients was assessed utilising a validated 168-item semi-quantitative FFQ, and methyl donor micronutrient score (MDMS) was calculated. The muscle strength of the participants was measured using a digital handgrip dynamometer. The association was determined using linear regression analysis. The mean age of participants was 36·8 ± 13·2 years. After taking into account potential confounding variables, there was no significant association between dietary methyl donor micronutrient score (MDMS) and the mean left-hand muscle strength (β: 0·07, se: 0·05, P = 0·07); however, the changes were significant in the mean right-hand muscle strength (β: 0·09, se: 0·04, P = 0·03). There was also a significant positive relationship between mean muscle strength and methyl donors' intake after fully adjusting for potential confounders (β: 0·08, se: 0·04, P = 0·04). In conclusion, our findings revealed that higher dietary methyl donor micronutrient consumption is associated with enhanced muscle strength. As a result, advice on a higher intake of methyl donor-rich foods including grains, nuts, dairy products and seafood might be recommended by dietitians as a general guideline to adhere to. Additional prospective studies are needed to confirm the findings.
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Affiliation(s)
- Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Parisa Radkhah
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mahla Chambari
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nadia Babaee
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Rodríguez-Gutiérrez E, Torres-Costoso A, Lucas-de la Cruz L, Mesas AE, Martínez-Vizcaíno V, Díez-Fernández A. The impact of reduced muscular fitness on cardiometabolic risk factors in children aged 9-11 years. Acta Paediatr 2024. [PMID: 38403778 DOI: 10.1111/apa.17178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
AIM To analyse the relationships between muscular fitness (MF), fat mass (FM), fat-free mass (FFM) and its combined ratio with cardiometabolic risk (CMR) and whether the relationship between MF and CMR is mediated by body composition in schoolchildren. METHODS A cross-sectional study was conducted on schoolchildren from Cuenca, Spain, between September and November 2017. FM and FFM were estimated using bioimpedance analysis. The CMR index was calculated from triglycerides-HDL-c ratio, arterial pressure and fasting insulin. The MF index was assessed using handgrip and standing long jump tests. Analysis of covariance models assessed CMR index differences across the MF index and the FM/FFM ratio categories. Mediation analysis examined whether the MF index and the CMR index association were mediated by FM, FFM or FM/FFM ratio. RESULTS The analyses involved 485 schoolchildren aged 9-11 years (55.4% girls). Children with a higher MF index had a lower CMR index (p < 0.05). This association did not persist after controlling for FM/FFM. FM, FFM and FM/FFM ratio mediated the relationship between the MF index and the CMR index. CONCLUSION Better levels of MF are associated with better cardiometabolic profile, but a healthy body composition is determinant to improve future health.
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Affiliation(s)
- Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Lidia Lucas-de la Cruz
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Arthur E Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Ana Díez-Fernández
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
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Li G, Lu Y, Shao L, Wu L, Qiao Y, Ding Y, Ke C. Handgrip strength is associated with risks of new-onset stroke and heart disease: results from 3 prospective cohorts. BMC Geriatr 2023; 23:268. [PMID: 37142986 PMCID: PMC10161641 DOI: 10.1186/s12877-023-03953-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Stroke and heart disease are two major contributors to the global disease burden. We aimed to evaluate and compare the roles of different handgrip strength (HGS) expressions in predicting stroke and heart disease in three nationally representative cohorts. METHODS This longitudinal study used data from the Health and Retirement Study (HRS), the Survey of Health, Ageing, and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). The Cox proportional hazard model was applied to analyze the relationship between HGS and stroke and heart disease, and Harrell's C index was used to assess the predictive abilities of different HGS expressions. RESULTS A total of 4,407 participants suffered from stroke and 9,509 from heart disease during follow-up. Compared with the highest quartile, participants in the lowest quartile of dominant HGS, absolute HGS and relative HGS possessed a significantly higher risk of new-onset stroke in Europe, America, and China (all P < 0.05). After adding HGS to office-based risk factors, there were minimal or no differences in the increases of Harrell's C indexes among three HGS expressions. In contrast, the modest association between HGS and heart disease was only seen in SHARE and HRS, but not in CHARLS. CONCLUSION Our findings support that HGS can be used as an independent predictor of stroke in middle-aged and older European, American and Chinese populations, and the predictive ability of HGS may not depend on how it is expressed. The relationship between HGS and heart disease calls for further validation.
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Affiliation(s)
- Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China
| | - Yi Ding
- Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, 215009, Suzhou, P. R. China.
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China.
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C-reactive protein and muscle-related measures over 14 years in Chinese community-dwelling older adults. Arch Gerontol Geriatr 2023; 106:104878. [PMID: 36470180 DOI: 10.1016/j.archger.2022.104878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Inflammation has been proposed to initiate the development of cachexia and is a driver of skeletal muscle loss. It raised the question of whether inflammation may also predict the age-related decline in muscle-related measures. This study explored the longitudinal association between high-sensitivity C-reactive protein (hsCRP) and muscle-related measures over a 14-year follow-up period, among Chinese community-dwelling older adults ≥65 years. METHODS Data was derived from the Mr. and Ms. Osteoporosis (Hong Kong) study. hsCRP was measured at baseline as a marker of inflammation. Muscle-related measures including handgrip strength, gait speed, chair-stand test (CST) and appendicular skeletal muscle mass/height2 (ASM/ht2, using dual-energy x-ray absorptiometry) were measured at baseline, 2-, 4-, 7- (except CST and ASM/ht2) and 14-year follow up. Adjusted linear mixed models were used to examine associations between baseline sex-specific tertiles of hsCRP and changes in muscle-related measures. RESULTS 2534 participants were included (mean age 72.3 ± 5.1 years, 49.4% female). There were significant time changes in all muscle-related measures (all p for time <0.001). Participants in the higher tertile of hsCRP had poorer handgrip strength and gait speed and a higher ASM/ht2 compared with those in the lower tertile of hsCRP (all p < 0.05). A higher tertile of hsCRP did not predict the decline in muscle-related measures (all p for hsCRP tertile x time interaction >0.05). CONCLUSIONS This prospective study suggests that, among Chinese community-dwelling older adults, baseline inflammatory state as measured by hsCRP was not associated with the decline in muscle-related measures over a long period of time.
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Lopez-Jaramillo P, Lopez-Lopez JP, Tole MC, Cohen DD. Increasing muscular strength to improve cardiometabolic risk factors. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS 2022:S0214-9168(22)00136-X. [DOI: 10.1016/j.arteri.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
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Hong S, Oh M, Kim Y, Jeon JY. Association of Absolute and Relative Handgrip Strength with Prevalent Metabolic Syndrome in Adults: Korea National Health and Nutrition Examination Survey 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12585. [PMID: 36231885 PMCID: PMC9564627 DOI: 10.3390/ijerph191912585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Maintaining or improving muscular strength may be a key preventive strategy for metabolic syndrome (MetS). However, whether the association of handgrip strength (HGS), as a well-established marker of whole-body muscular strength, with the prevalent metabolic syndrome (MetS) varies with age stratification remains unclear. Additionally, whether absolute of relative HGS is superior to another in predicting MetS is less clear. We examined the association of both relative and absolute HGS with the prevalence of MetS in different age groups. Korean adults aged ≥19 years (n = 28,146; 55.7% female) from the Korean National Health and Nutrition Examination Survey (2014-2018) were examined. HGS was categorized using tertile split (highest, intermediate, lowest) and participants were stratified into different age groups at 10-year intervals. Multivariable logistic regression models were used to examine the association between absolute/relative HGS tertiles and MetS with adjustment for covariates. Lower odds of MetS were observed across lower absolute HGS tertiles and the associations were significant in young participants (19-29 years) in both sexes (odds ratio (OR): 0.59 (95% CI: 0.38-0.92) for intermediate and OR: 0.55 (95% CI: 0.34-0.89) for lowest in males; OR: 0.36 (95% CI: 0.20-0.65) for intermediate and OR: 0.42 (95% CI: 0.24-0.74) for lowest in females; all p < 0.05). By contrast, higher odds of MetS were observed across lower relative HGS in all age groups in both sexes (in total participants, OR: 2.32 (95% CI: 2.06-2.62) for intermediate and OR: 3.69 (95% CI: 3.27-4.16) for lowest in males and OR: 2.04 (95% CI: 1.83-2.28) for intermediate and OR: 3.28 (95% CI: 2.94-3.65) for lowest in females all p < 0.05). The associations of both absolute and relative HGS with MetS attenuated with an increase in age. Our findings suggest that poor relative HGS, as a marker of muscular strength, and not absolute HGS, may be associated with a higher risk of MetS in adults. Our findings also suggest that relative HGS may overestimate MetS in young adults.
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Affiliation(s)
- Sunghyun Hong
- Exercise Medicine and Rehabilitation Laboratory, Department of Sport Industry Studies, Yonsei University, Seoul 03722, Korea
| | - Minsuk Oh
- Department of Public Health, Baylor University, Waco, TX 76798, USA
| | - Youngwon Kim
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Justin Y. Jeon
- Exercise Medicine and Rehabilitation Laboratory, Department of Sport Industry Studies, Yonsei University, Seoul 03722, Korea
- Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul 03722, Korea
- Cancer Prevention Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
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Chang CY, Chu NF, Lin MH, Wang SC, Wu DM, Tsai MK, Lu CH. Association between Grip Strength, Obesity, and Cardiometabolic Risk Factors among the Community-Dwelling Elderly Population in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11359. [PMID: 36141648 PMCID: PMC9517202 DOI: 10.3390/ijerph191811359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to evaluate the association between grip strength, obesity, and cardiometabolic risk factors among elderly individuals with different grip strength statuses and weight statuses in Taiwan. We conducted a series of community-based health surveys among the elderly population in Chiayi County, Taiwan from 2017 to 2019. This is a cross-sectionally designed health check-up program that was conducted by the local public health bureau. Anthropometric characteristics, handgrip strength, diabetes, and cardiometabolic risk profiles were measured using standard methods. This study recruited 3739 subjects (1600 males and 2139 females). The non-obese subjects had lower blood glucose (BG) levels compared to the obese subjects. The BG levels of non-obese and obese subjects were 102.7 ± 25.6 mg/dL vs. 109.1 ± 34.3 mg/dL for males; and 102.8 ± 30.1 mg/dL vs. 112.5 ± 40.3 mg/dL for females (both p < 0.001). The grip strength was negatively associated with BG in both sexes (β = -0.357, p < 0.001 for males and β = -0.385, p < 0.05 for females). The relationship between the grip strength and the risk of diabetes showed that for every 1 kg increase in the grip strength, there was a 4.1% and 4.5% decrease in the risk for developing diabetes for males and females, respectively (OR = 0.959, 95% CI = 0.940-0.979 for males and OR = 0.955, 95% CI = 0.932-0.978 for females). A higher handgrip strength is associated with a lower BG level and a lower risk for diabetes mellitus in the elderly Taiwanese subjects. Additional health promotion should focus on the obese and sarcopenic population to prevent cardiometabolic comorbidities in later life.
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Affiliation(s)
- Chun-Yung Chang
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802, Taiwan
| | - Nain-Feng Chu
- Division of Occupational Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
| | - Shu-Chuan Wang
- Division of Performance Management, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
| | - Der-Min Wu
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ming-Kai Tsai
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802, Taiwan
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan
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Lu Y, Li G, Ferrari P, Freisling H, Qiao Y, Wu L, Shao L, Ke C. Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity. BMC Med 2022; 20:191. [PMID: 35655218 PMCID: PMC9164350 DOI: 10.1186/s12916-022-02389-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiometabolic multimorbidity (CM) is an increasing public health and clinical concern. However, predictors for the development and prognosis of CM are poorly understood. The aims of this study were to investigate the relation between handgrip strength (HGS) and the risk of CM and to examine the association of HGS with all-cause mortality risk among patients with CM. METHODS This prospective cohort study involved 493,774 participants from the UK Biobank. CM was defined as the simultaneous occurrence of two or more of the following conditions: type 2 diabetes, stroke, and coronary heart disease (CHD). Cox proportional hazards models were performed to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During a median follow-up of 12.1 years, 4701 incident CM cases were documented among participants with none cardiometabolic disease at baseline. Compared with the fourth quartile (Q4), the multivariable adjusted HR (95% CI) value of Q1 of HGS for developing CM was 1.46 (1.34-1.60). In participants with one cardiometabolic disease at baseline, participants in Q1 of HGS also possessed higher risk of CM than those in Q4, with HRs (95% CIs) being 1.35 (1.23-1.49) in patients with type 2 diabetes, 1.23 (1.04-1.46) in patients with stroke, and 1.23 (1.11-1.36) in patients with CHD. For participants with CM at recruitment, HGS was also associated with the risk of all-cause mortality (Q1 vs. Q4 HR: 1.57, 95% CI: 1.36-1.80). CONCLUSIONS Our study provided novel evidence that HGS could be an independent predictor of morbidity and all-cause mortality of CM.
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Affiliation(s)
- Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC/WHO), Lyon, France
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Luying Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Liping Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, People's Republic of China.
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Shah SA, Safian N, Mohammad Z, Nurumal SR, Wan Ibadullah WAH, Mansor J, Ahmad S, Hassan MR, Shobugawa Y. Factors Associated with Handgrip Strength Among Older Adults in Malaysia. J Multidiscip Healthc 2022; 15:1023-1034. [PMID: 35586078 PMCID: PMC9109974 DOI: 10.2147/jmdh.s363421] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Handgrip strength (HGS) is indicative of overall physical health among older adults. A decrease in HGS may be associated with an increased risk of disease. The aim of this study is to determine the factors associated with HGS among older adults in Malaysia. Patients and Methods One thousand two hundred four (1204) participants from urban and rural areas in Selangor state, Malaysia, were recruited. Sociodemographic and health-related conditions were gathered through a comprehensive face-to-face interview, followed by HGS assessments by a handgrip dynamometer. Subsequently, multiple linear regression was used to test the main association with the HGS. Results A total of 691 participants (57.4%) were male, and 513 (42.6%) were female. Males had a mean HGS of 30.0 (SD 7.53) kg, and females had a mean HGS of 19.4 (SD 5.28) kg. Males’ handgrip strength was significantly reduced with increasing age, physically inactive, and diabetes (all at the level p<0.001) after adjusting for social-demographic characteristics and health-related variables. Meanwhile, for females, the HGS was significantly decreased with age (p<0.001), physically inactive (p<0.001) and hypertension (p=0.03). However, female HGS was positively related to BMI (p<0.001). Conclusion The study contributed to a better understanding of factors associated with HGS, and thus, the HGS is recommended as a section in the health evaluation among high-risk older adults as the strategy of disease control and prevention.
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Affiliation(s)
- Shamsul Azhar Shah
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
- Correspondence: Shamsul Azhar Shah, Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia, Tel +60 3-9145 8787, Fax +60 3-91456670, Email
| | - Nazarudin Safian
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Zulkefley Mohammad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Siti Rohani Nurumal
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Wan Abdul Hannan Wan Ibadullah
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Juliana Mansor
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Saharuddin Ahmad
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Yugo Shobugawa
- Department of Active Aging, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 951-8510, Japan
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Zheng J, Zhang L, Jiang M. Lower handgrip strength levels probably precede triglyceride glucose index and associated with diabetes in men not in women. J Diabetes Investig 2022; 13:148-155. [PMID: 34228900 PMCID: PMC8756317 DOI: 10.1111/jdi.13626] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/15/2021] [Accepted: 07/05/2021] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Jia Zheng
- Department of Clinical EpidemiologyThe Fourth Affiliated Hospital of China Medical UniversityShenyangChina
| | - Lu Zhang
- Department of Health ScienceDoctoral School of Health ScienceUniversity of PécsPécsHungary
| | - Min Jiang
- Department of EpidemiologySchool of Public HealthChina Medical UniversityShenyangChina
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Torres-Costoso A, Martínez-Vizcaíno V, Fernández-Rodríguez R, Sequí-Dominguez I, Reina-Gutiérrez S, Núñez de Arenas-Arroyo S, Garrido-Miguel M. Dietary Calcium Intake and Fat Mass in Spanish Young Adults: The Role of Muscle Strength. Nutrients 2021; 13:nu13124498. [PMID: 34960051 PMCID: PMC8705271 DOI: 10.3390/nu13124498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 01/01/2023] Open
Abstract
Obesity is declared as a chronic multifaceted health problem, and young adults may be particularly vulnerable to weight gain. This study aims to identify the role of dietary calcium intake and the muscle strength index in handling excess of fat mass in young adults and to examine if the relationship between dietary calcium intake and fat mass percentage is mediated by muscle strength. A cross-sectional study including 355 Spanish college students (aged 21.05 ± 3.11) was performed during the 2017–2018 academic year. Pearson correlation coefficients were estimated to determine the relationship between dietary calcium intake, fat mass percentage, body mass index, muscle strength components, and total energy intake. ANCOVA models were used to analyze the differences in the muscle strength index by total dietary calcium intake categories, as well as the differences in % fat mass by total dietary calcium intake and muscle strength index categories, controlling for different sets of confounders. A mediator analysis was conducted to test if the relationship between dietary calcium intake and fat mass percentage was explained by muscle strength. Data on the fat mass percentage, dietary calcium intake, and muscle strength index as the sum of the standardized z-score of the standing long jump and z-score of handgrip/weight were collected. The muscle strength index was significantly better in young adults with higher dietary calcium intake. Moreover, the fat mass percentage was significantly lower in those with a higher dietary calcium intake and a better muscle strength index. Finally, the relationship between dietary calcium intake and fat mass percentage was fully mediated by muscle strength (z = −1.90; p < 0.05), explaining 33.33% of this relationship. This study suggests that both a major dietary calcium intake and muscle strength are associated with fat mass percentage. Moreover, muscle strength mediates the link between dietary calcium intake and fat mass percentage. Therefore, both high dietary calcium intake and exercise activities aimed at improving muscle strength levels may help to prevent the cardiometabolic risk associated with an excess of fat mass in young people.
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Affiliation(s)
- Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain;
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Vicente Martínez-Vizcaíno
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3467987, Chile
- Correspondence: ; Tel.: +34-969179100
| | - Rubén Fernández-Rodríguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Irene Sequí-Dominguez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sara Reina-Gutiérrez
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Sergio Núñez de Arenas-Arroyo
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
| | - Miriam Garrido-Miguel
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; (R.F.-R.); (I.S.-D.); (S.R.-G.); (S.N.d.A.-A.); (M.G.-M.)
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, 02006 Ciudad Real, Spain
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Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population. NUTR HOSP 2021; 39:82-92. [PMID: 34816725 DOI: 10.20960/nh.03732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
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.
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15
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Alkahtani S. Association between Adjusted Handgrip Strength and Metabolic Syndrome in Arab Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010898. [PMID: 34682654 PMCID: PMC8536103 DOI: 10.3390/ijerph182010898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Shaea Alkahtani
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia
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16
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Kim YN, Jung JH, Park SB. Changes in high-sensitivity C-reactive protein levels and metabolic indices according to grip strength in Korean postmenopausal women. Climacteric 2021; 25:306-310. [PMID: 34423694 DOI: 10.1080/13697137.2021.1965116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study aimed to investigate the changes in high-sensitivity C-reactive protein (hs-CRP) level and metabolic indices such as blood pressure, serum lipid level and serum glucose level according to grip strength in postmenopausal women. METHOD Data from participants (postmenopausal women) in the Seventh Korea National Health and Nutrition Examination Survey 2018 were analyzed. Absolute handgrip strength was the sum of the maximal grip strength of both hands, and relative handgrip was calculated as absolute handgrip divided by the body mass index. We performed linear regression analysis after adjusting for confounders to assess the influence of grip strength on hs-CRP level and metabolic indices. RESULTS Linear regression analysis showed that after adjusting for confounders, with an increased absolute grip strength, systolic blood pressure and hs-CRP levels were decreased; however, the changes were not significant for the remaining indices. Relative grip strength was associated with hs-CRP levels and metabolic indices. With a high relative grip strength, hs-CRP, blood pressure, fasting blood glucose, hemoglobin A1c and triglyceride levels were decreased, while the high-density lipoprotein cholesterol level was increased. CONCLUSION Our study evaluated the overall health status using grip strength in postmenopausal women. The grip strength adjusted by body size was suitable in evaluating the overall health status, including inflammatory and metabolic indices. Additionally, increased grip strength was associated with a better health status in postmenopausal women.
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Affiliation(s)
- Y N Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - J-H Jung
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S B Park
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
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17
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Li G, Qiao Y, Lu Y, Liu S, Ding Y, Chen X, Ke C. Role of handgrip strength in predicting new-onset diabetes: findings from the survey of health, ageing and retirement in Europe. BMC Geriatr 2021; 21:445. [PMID: 34325672 PMCID: PMC8320209 DOI: 10.1186/s12877-021-02382-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, China
| | - Yi Ding
- Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, 215009, Suzhou, China.
| | - Xing Chen
- Department of Children Health Care Affiliated, Suzhou Hospital of Nanjing Medical University, No.26, Dao Qian Road, 215000, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, China.
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Lee J. Grip Strength as a Cardiometabolic Marker. Korean J Fam Med 2020; 41:271-272. [PMID: 32961045 PMCID: PMC7509118 DOI: 10.4082/kjfm.41.5e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jungun Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
- *Corresponding Author: Jungun Lee https://orcid.org/0000-0001-8580-1445 Tel: +82-31-390-2416, Fax: +82-31-390-2266, E-mail:
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