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Independent and joint associations of grip strength and adiposity with all-cause and cardiovascular disease mortality in 403,199 adults: The UK Biobank study
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Abstract
Background
Higher grip strength (GS) is associated with lower mortality risk. However, whether this association is independent of adiposity is uncertain.
Objective
The purpose of this study was to examine the associations between GS, adiposity and mortality.
Design
The UK Biobank study is an ongoing prospective cohort of >0.5 million UK adults aged 40-69 years. Baseline data collection (2006-2010) included measurements of GS and adiposity indicators including body mass index (BMI). Age- and gender-specific GS quintiles were used. BMI was classified according to clinical cut-points.
Results
Data from 403,199 participants were included in analyses. Over a median 7.0-year follow-up, 8,287 all-cause deaths occurred. The highest GS quintile had 32% (95% confidence interval [CI]: 26%, 38%) and 25% (95% CI: 16%, 33%) lower all-cause mortality risks in men and women, respectively, compared with the lowest GS quintile, after adjustment for confounders and BMI. Obesity class II (BMI≥35) was associated with greater all-cause mortality risks. Compared with the highest GS and normal weight category, the highest GS and Obesity class II category showed relatively higher all-cause mortality hazards (not statistically significant in men); however, the increased risk was relatively lower than the risk for the lowest GS and Obesity class II category. All-cause mortality risks were generally lower for obese but stronger individuals than for non-obese but weaker individuals. Similar patterns of associations were observed for cardiovascular mortality.
Conclusions
Lower grip strength and excess adiposity are both independent predictors of higher mortality risk. The higher mortality risk associated with excess adiposity is attenuated, although not completely attenuated, by greater GS. Interventions/polices should focus on improving muscular strength of the population regardless of their adiposity levels.