Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014-2015 Korea National Health and Nutrition Examination Survey

Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations

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.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people

OBJECTIVES

This study aimed to examine the association of absolute and relative hand grip strength (HGS) with the risk of all-cause mortality among middle-aged and old-aged people in South Korea. Considering that both absolute HGS and relative HGS could be effective measures, an in-depth investigation is necessary to compare the effects of both measures on mortality.

METHODS

Data of 9,102 participants, derived from the Korean Longitudinal Study of Aging from 2006 to 2018, were examined. HGS was divided into two categories: absolute HGS and relative HGS (defined as HGS divided by body mass index). The risk of all-cause mortality was the dependent variable. Cox proportional hazard regression was used to analyze the association between HGS and all-cause mortality.

RESULTS

The average of absolute and relative HGS were 25.6 ± 8.7 kg and 1.1 ± 0.4 kg/BMI, respectively. The all-cause mortality rate decreased by 3.2% as absolute HGS increased by 1 kg (adjusted hazard ratio [HR] = 0.968, 95% CI = 0.958-0.978). An increase in relative HGS by 1 kg/BMI was associated with a 22% reduction in risk of all-cause mortality (adjusted HR = 0.780, 95% CI = 0.634-0.960). Individuals with more than two chronic diseases, there was a decrease in all-cause mortality as absolute HGS increased by 1 kg and relative HGS by 1 kg/BMI (absolute HGS; adjusted HR = 0.97, 95% CI = 0.959-0.982, relative HGS; adjusted HR = 0.483, 95% CI = 0.325-0.718).

CONCLUSIONS

Our study findings showed that both absolute and relative HGS were inversely associated with the risk of all-cause mortality; a higher absolute/relative HGS was associated with a lower risk of all-cause mortality. Moreover, these findings highlight the importance of improving HGS to alleviate the burden of adverse health problems.

Stroke-Related Sarcopenia among Two Different Developing Countries with Diverse Ethnic Backgrounds (Cross-National Study in Egypt and China)

The prevalence of stroke-related sarcopenia differs according to the diagnostic criteria, the cut-off point for assessment, and ethnicity. Egypt and China are developing countries with different races where no research concerning stroke-related sarcopenia has been performed yet. We aimed to evaluate the prevalence of possible sarcopenia and confirmed sarcopenia among Egyptian and Chinese stroke survivors using the Asian Working Group of Sarcopenia (AWGS-2019) criteria and to assess the variables associated with the prevalence rate. A prospective cross-sectional study was carried out among 200 Egyptian and 195 Chinese stroke survivors from 2019 to 2021 using a structural health questionnaire. A hand-held dynamometer was used to measure grip strength. Anthropometric measures were used to estimate muscle mass. Data were analyzed using SPSS statistics version 20. p-values < 0.05 were considered statistically significant. The prevalence of possible sarcopenia ranged from 20.0% to 34.4% among Egyptian and Chinese groups, except for the Egyptian females where it was 52.0%. The prevalence of sarcopenia in both populations ranged from 13.6% to 18.6%. Pre-stroke independent variables that accelerated possible sarcopenia were age, history of dyslipidemia, diabetes mellitus, and ischemic heart disease, but stroke severity was a post-stroke risk factor. Age was the only pre-stroke variable for sarcopenia, while quitting smoking and having good nutritional status were variables for the reduction of possible sarcopenia. Quitting smoking, having a good nutritional status, and early rehabilitation reduced sarcopenia development. Controlling vascular risk factors, enhancing rehabilitation, and nutritional therapy are protective measures against sarcopenia. Longitudinal studies are required to identify further risk factors.

Association Between C-Reactive Protein and Relative Handgrip Strength in Postmenopausal Korean Women Aged 45-80 Years: A Cross-Sectional Study

Background

Chronic inflammation plays a key role in the pathophysiology of frailty and loss of physical performance, which are closely associated with sarcopenia. In women, the decline in muscle mass and strength is accelerated after menopause. Thus, we examined the association between high sensitivity C-reactive protein (hs-CRP) and relative handgrip strength (HGS) in postmenopausal women.

Methods

This cross-sectional study included 2171 postmenopausal women aged ≥45 years who participated in the Korean National Health and Nutrition Survey (KNHNES) between 2015 and 2018. Relative HGS was categorized into quartiles as follows: Q1, <0.810 (kg/BMI); Q2, 0.810–0.968 (kg/BMI); Q3, 0.969–1.119 (kg/BMI); Q4, >1.119 (kg/BMI). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for high hs-CRP (>1.0 mg/L, 75 percentile of the current samples) were calculated across relative HGS quartiles using multiple logistic regression analysis.

Results

The prevalence of high hs-CRP decreased with relative HGS quartiles. Compared to the highest quartile, the OR (95% CI) of the lowest relative HGS quartile for high hs-CRP was 3.266 (2.227–4.789) after adjusting for age, hypertension, diabetes mellitus, dyslipidemia, education, household income, physical activity, strength exercise, smoking, and alcohol ingestion.

Conclusion

Serum hs-CRP level was inversely and independently associated with relative HGS. Our findings indicate that low-grade inflammation is inversely associated with muscle strength in postmenopausal women.

Association between Relative Handgrip Strength and Insulin Resistance in Korean Elderly Men without Diabetes: Findings of the 2015 Korea National Health Nutrition Examination Survey

BACKGROUND

Evidence regarding the association between handgrip strength (HGS) and insulin resistance in a non-diabetic population is scarce. This study aimed to investigate the association between relative HGS and insulin resistance in older men without diabetes, using a representative sample of the Korean male population.

METHODS

The study population comprised 206 participants aged 65-80 years, selected from the 2015 Korea National Health and Nutrition Examination Survey. Insulin resistance was defined as the upper tertile of the homeostatic model assessment of insulin resistance (HOMA-IR). Odds ratios and 95% confidence intervals for insulin resistance were assessed using multiple logistic regression analyses after adjusting for confounding variables.

RESULTS

The prevalence of insulin resistance decreased with increasing relative HGS. The prevalence in the T1, T2, and T3 groups was 46.0%, 32.2%, and 26.4%, respectively. Compared with the individuals in the highest tertile of relative HGS, the odds ratio (95% confidence interval) for insulin resistance in individuals in the lowest quartile was 2.82 (1.10-7.21) after adjusting for age, smoking, alcohol consumption, aerobic exercise, resistance exercise, systolic blood pressure, total cholesterol, residential area, household income, and education level.

CONCLUSION

Lower relative HGS was inversely associated with an increased risk of insulin resistance in older Korean men without diabetes. In clinical practice, relative HGS, which is a simple and inexpensive tool, could be a useful measure for identifying older men with insulin resistance. Moreover, these findings suggest that muscle strengthening exercises should be considered to reduce insulin resistance and increase insulin sensitivity.

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 relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014)

OBJECTIVES

This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20-69.

METHODS

Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20-69 years in four successive national surveys (2000-2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension.

RESULTS

The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40-1.47), 58% (OR = 1.58, 95%CI: 1.54-1.62), 48% (OR = 1.48, 95%CI: 1.45-1.52), 43% (OR = 1.43, 95%CI: 1.40-1.47), respectively.

CONCLUSION

In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.

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.