Research Review: Linking Handgrip Strength and Prediabetes
Chrispin MM, et al. Handgrip strength predicts new prediabetes cases among adults. A prospective cohort study. Prev Med Rep 2020;17:101056.
In 2017 there were 451 million people with diabetes, and 5 million related deaths. And, prevalence rates are expected to rise to 693 million by 2045. Before developing type 2 diabetes, individuals undergo an intermediate state termed prediabetes, characterized by blood glucose concentrations higher than normal, but not high enough for a full diabetes diagnosis.
Handgrip strength, a simple measure of muscle strength correlates well with other strength measures and also has been shown to negatively associate with metabolic syndrome, type 2 diabetes, and overall wellness. Many studies report that muscle strengthening activities that improve muscle function and also influence glucose deposition that favors insulin-mediated glucose uptake in skeletal muscle, rather than in adipose tissue. The results of these studies suggest that muscle strength (a proxy measure of muscle quality) may be an importantfactor in the development of prediabetes and type 2 diabetes.
Study whether handgrip strength can be used to identify individuals at high risk of prediabetes. Additionally, this study investigated whether relative handgrip strength would predict prediabetes incidence among adults participating in annual medical examinations in Japan after a 2 year follow-up.
This prospective study recruited 2054 individuals without prediabetes or diabetes, each person performed a handgrip strength measurement during a medical examinations April 2016 and March 2017. Individuals younger than age 20 or older than age 75, or had a history of stroke, heart disease, or chronic renal failure were excluded from the study.
The following data were included in the analyses: absolute and relative hand-grip strength; waist girth; body mass index (BMI; calculated as WT/HT2); hypertension defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medication; dyslipidemia defined as triglycerides ≥150 mg/dL, LDL-cholesterol ≥140 mg/dL, HDL-cholesterol <40 mg/dL, or self-reported use of anticholesteremic agents. Data were also collected during a 24.2 month follow-up. Comparisons were made between males versus females pre and post testing, and relationships between absolute and relative hand-grip strength (absolute strength/BMI) and different biologic variables that reflect prediabetes and a full diabetes diagnosis were made.
Similar and significant results were observed among individuals younger than age 40 and those older than age 40, or older after adjusting for age (continuous), sex, current smoking, dyslipidemia, alcohol consumption frequency, hypertension and regular physical activity. Importantly, a unit increase in relative handgrip strength predicted a lower and significant risk of prediabetes incidence among individuals with normal BMI (18.5–24.9 kg/m2). And, a lower but not significant risk was also observed among those with BMI ≥25.0 kg/m2 after adjusting for age (continuous), sex, current smoking, dyslipidemia, alcohol consumption frequency, hypertension and regular physical activity.
Additional analysis using sex and age adjusted relative handgrip strength produced similar results. Those in the middle and upper hand-grip strength groups clearly exhibited lower risk of prediabetes incidence compared to those in the lower hand-grip strength group.
The major study findings indicate that relative handgrip strength predicts prediabetes incident among a sample of Japanese adults. Fifteen percent of individuals had incident prediabetes within 2 years of follow-up, suggesting a high risk of prediabetes among the participants.
The second important finding of this study was that relative handgrip strength predicted a lower and significant risk of prediabetes incidence among individuals with normal BMIs (18.5–24.9 kg/m2).
The use of handgrip strength, a simple measure of muscle strength, may have utility in the identification of individuals at high risk of prediabetes who can then be targeted for intervention. Participants of annual medical examinations could be motivated to improve muscle strength after understanding the risk that lower relative strength may indicate for future prediabetes incidence.