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      Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes

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          Abstract

          Handgrip strength is useful for the diagnosis of sarcopenia. We examined the associations of handgrip strength with all-cause mortality, cardiovascular events, and hospitalization in patients with type 2 diabetes. From April 2013 to December 2015, we conducted a retrospective cohort study to examine patients with type 2 diabetes whose handgrip strength was measured at our hospital. All patients were followed up until May 2016. A total of 1,282 patients (63.8 ± 13.9 years) were enrolled and followed up for 2.36 ± 0.73 years. During the follow-up period, 20 patients (1.6%) died, 14 (1.1%) experienced cardiovascular events, and 556 (43.4%) were admitted to our hospital for any diseases. Multiple regression analyses revealed that handgrip strength was favorably associated with abdominal obesity and renal function. Moreover, Cox proportional hazard analyses with adjustment for potential confounding variables revealed that handgrip strength was significantly associated with occurrence of CVD events and hospitalization in all subjects. In addition, handgrip strength was significantly associated with mortality and hospitalization in men and with hospitalization in women. Handgrip strength could be a prognostic indicator for health as well as a diagnostic marker of skeletal muscle mass loss in Japanese patients with type 2 diabetes.

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          Association of body size and muscle strength with incidence of coronary heart disease and cerebrovascular diseases: a population-based cohort study of one million Swedish men.

          G. Batty, Per Tynelius, Patrik K. E. Magnusson … (2009)
          Muscle strength and body size may be associated with coronary heart disease (CHD) and stroke risk. However, perhaps because of a low number of cases, existing evidence is inconsistent. Height, weight, systolic (SBP) and diastolic blood pressure (DBP), elbow flexion, hand grip and knee extension strength were measured in young adulthood in 1 145 467 Swedish men born between 1951 and 1976. Information on own and parental social position was derived from censuses. During the register-based follow-up until the end of 2006, 12 323 CHD and 8865 stroke cases emerged, including 1431 intracerebral haemorrhage, 1316 subarachoid haemorrhage and 2944 intracerebral infarction cases. Hazard ratios (HR) per 1 SD in the exposures of interest were computed using Cox proportional hazard model. Body mass index (BMI, kg/m(2)) showed increased risk with CHD and intracerebral infarction, whereas for intracerebral and subarachoid haemorrhage both under- and overweight was associated with increased risk. Height was inversely associated with CHD and all types of stroke. After adjustment for height, BMI, SBP, DBP and social position, all strength indicators were inversely associated with disease risk. For CHD and intracerebral infarction, grip strength showed the strongest association (HR = 0.89 and 0.91, respectively) whereas for intracerebral and subarachoid haemorrhage, knee extension strength was the best predictor (HR = 0.88 and 0.92, respectively). Body size and muscle strength in young adulthood are important predictors of risk of CHD and stroke in later life. In addition to adiposity, underweight needs attention since it may predispose to cerebrovascular complications.
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            Effective exercise modality to reduce insulin resistance in women with type 2 diabetes.

            J. Frohlich, Hugh Tildesley, Graydon S Meneilly … (2003)
            The purpose of this study was to evaluate whether a combined resistance and aerobic training program would improve insulin sensitivity compared with aerobic training alone in postmenopausal women with type 2 diabetes. A second objective was to relate the improved insulin sensitivity to changes in abdominal adipose tissue (AT) and thigh muscle density. A total of 28 obese postmenopausal women with type 2 diabetes were randomly assigned to one of three 16-week treatments: control, aerobic only training (Ae only), or aerobic plus resistance training (Ae+RT). Pre- and posttreatment outcome measures included glucose disposal by hyperinsulinemic-euglycemic clamp and computed tomography scans of abdominal AT and mid-thigh skeletal muscle. Glucose infusion rates increased significantly (P < 0.05) in the Ae+RT group. Both exercise groups had reduced abdominal subcutaneous and visceral AT and increased muscle density. The Ae+RT training group exhibited a significantly greater increase in muscle density than the Ae only group. Improved glucose disposal was independently associated with changes in subcutaneous AT, visceral AT, and muscle density. Muscle density retained a relationship with glucose disposal after controlling for abdominal AT. Adding resistance training to aerobic training enhanced glucose disposal in postmenopausal women with type 2 diabetes. The improved insulin sensitivity is related to loss of abdominal subcutaneous and visceral AT and to increased muscle density.
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              Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes.

              Michael Leitzmann, Mihaela Tanasescu, Frank Hu … (2003)
              The present study was conducted to examine the relationship of physical activity with risk of cardiovascular disease (CVD) and mortality among men with type 2 diabetes. CVD risk and mortality are increased in type 2 diabetes. Few epidemiological studies have investigated the effect of physical activity on these outcomes among type 2 diabetics. Of the 3058 men who reported a diagnosis of diabetes at age 30 years or older in the Health Professionals' Follow-up Study (HPFS), we excluded 255 who reported a physical impairment. In the remaining 2803 men, physical activity was assessed every 2 years; 266 new cases of CVD and 355 deaths of all causes were identified during 14 years of follow-up. Relative risks of CVD and death were estimated from Cox proportional hazards analysis with adjustment for potential confounders. The multivariate relative risks of CVD incidence corresponding to quintiles of total physical activity were 1.0, 0.87, 0.64, 0.72, and 0.67 (Ptrend=0.07). The corresponding multivariate relative risks for total mortality were 1.0, 0.80, 0.57, 0.58, and 0.58 (Ptrend=0.005). Walking was associated with reduced risk of total mortality. Relative risks across quintiles of walking were 1.0, 0.97, 0.87, 0.97, and 0.57 (Ptrend=0.002). Walking pace was inversely associated with CVD, fatal CVD, and total mortality independently of walking hours. Physical activity was associated with reduced risk of CVD, cardiovascular death, and total mortality in men with type 2 diabetes. Walking and walking pace were associated with reduced total mortality.
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                Author and article information

                Contributors
                Hidetaka Hamasaki:
                ORCID: http://orcid.org/0000-0002-0124-597X
                hhamasaki78@gmail.com
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 1 August 2017
                Publication date PMC-release: 1 August 2017
                Publication date Collection: 2017
                Volume: 7
                Electronic Location Identifier: 7041
                Affiliations
                [1 ]ISNI 0000 0004 0489 0290, GRID grid.45203.30, Department of Internal Medicine, , National Center for Global Health and Medicine Kohnodai Hospital, ; 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516 Japan
                [2 ]Hamasaki Clinic, 2-21-4, Nishida, Kagoshima, 890-0046 Japan
                [3 ]ISNI 0000 0004 0492 602X, GRID grid.429051.b, Institute for Clinical Diabetology, , German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, ; Auf’m Hennekamp 65, Düsseldorf, 40225 Germany
                [4 ]ISNI 0000 0001 2168 5385, GRID grid.272242.3, Epidemiology and Prevention Group, , Center for Public Health Sciences, National Cancer Center, ; 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
                Author information
                http://orcid.org/0000-0002-0124-597X
                Article
                Publisher ID: 7438
                DOI: 10.1038/s41598-017-07438-8
                PMC ID: 5539205
                PubMed ID: 28765572
                SO-VID: 890b9ac0-bbf8-4461-bff1-8c6078afb754
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 16 March 2017
                Date accepted : 28 June 2017
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2017

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