Low Normalized Grip Strength is a Biomarker for Cardiometabolic Disease and Physical Disabilities Among U.S. and Chinese Adults

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Abstract

<div class="section"> <a class="named-anchor" id="s25">  </a> <h5 class="section-title" id="d4532642e211">Background</h5> <p id="d4532642e213">Evidence highlights the importance of muscular strength as a protective factor for health and function across aging populations. The purpose of this study was to examine the extent to which low normalized grip strength (NGS) serves as a biomarker for both cardiometabolic disease and physical disability in U.S. and Chinese adults. </p> </div><div class="section"> <a class="named-anchor" id="s26">  </a> <h5 class="section-title" id="d4532642e216">Methods</h5> <p id="d4532642e218">Middle aged and older adults from the U.S. National Health and Nutrition Examination Survey 2011–2012 and 2013–2014 combined surveys ( <i>n</i> = 4,544), and the 2011 wave of the China Health and Retirement Longitudinal Study ( <i>n</i> = 6,030) were included. Strength was assessed using a handgrip dynamometer, and was normalized to body mass. Weighted logistic regression models were used to assess the association between NGS and diabetes, hyperglycemia, hypertriglyceridemia, low HDL-cholesterol, hypertension, and physical disability status, while controlling for age, sex, and sociodemographic characteristics. </p> </div><div class="section"> <a class="named-anchor" id="s27">  </a> <h5 class="section-title" id="d4532642e227">Results</h5> <p id="d4532642e229">Every 0.05 lower NGS was independently associated with a 1.49 (95% confidence interval [CI]: 1.42–1.56) and 1.17 (95% CI: 1.11–1.23) odds for diabetes; a 1.46 (95% CI: 1.39–1.53) and 1.11 (95% CI: 1.07–1.15) odds of hyperglycemia; a 1.15 (95% CI: 1.07–1.25) and 1.11 (95% CI: 1.08–1.14) odds of hypertriglyceridemia; a 1.22 (95% CI: 1.17–1.27) and 1.15 (95% CI: 1.12–1.18) odds of low HDL-cholesterol; a 1.19 (95% CI: 1.14–1.24) and 1.10 (95% CI: 1.07–1.14) odds of hypertension; and a 1.36 (95% CI: 1.29–1.42) and 1.10 (95% CI: 1.05–1.15) odds for physical disability status in U.S. and Chinese adults, respectively. </p> </div><div class="section"> <a class="named-anchor" id="s28">  </a> <h5 class="section-title" id="d4532642e232">Conclusions</h5> <p id="d4532642e234">NGS was robustly associated with both cardiometabolic disease risk and physical disabilities in U.S. and Chinese aging adults. </p> </div>

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Criteria for Clinically Relevant Weakness and Low Lean Mass and Their Longitudinal Association With Incident Mobility Impairment and Mortality: The Foundation for the National Institutes of Health (FNIH) Sarcopenia Project

Robert R McLean, Michelle Shardell, Dawn E. Alley … (2014)

Background. This analysis sought to determine the associations of the Foundation for the National Institutes of Health Sarcopenia Project criteria for weakness and low lean mass with likelihood for mobility impairment (gait speed ≤ 0.8 m/s) and mortality. Providing validity for these criteria is essential for research and clinical evaluation. Methods. Among 4,411 men and 1,869 women pooled from 6 cohort studies, 3-year likelihood for incident mobility impairment and mortality over 10 years were determined for individuals with weakness, low lean mass, and for those having both. Weakness was defined as low grip strength (<26kg men and <16kg women) and low grip strength-to-body mass index (BMI; kg/m2) ratio (<1.00 men and <0.56 women). Low lean mass (dual-energy x-ray absorptiometry) was categorized as low appendicular lean mass (ALM; <19.75kg men and <15.02kg women) and low ALM-to-BMI ratio (<0.789 men and <0.512 women). Results. Low grip strength (men: odds ratio [OR] = 2.31, 95% confidence interval [CI] = 1.34–3.99; women: OR = 1.99, 95% CI 1.23–3.21), low grip strength-to-BMI ratio (men: OR = 3.28, 95% CI 1.92–5.59; women: OR = 2.54, 95% CI 1.10–5.83) and low ALM-to-BMI ratio (men: OR = 1.58, 95% CI 1.12–2.25; women: OR = 1.81, 95% CI 1.14–2.87), but not low ALM, were associated with increased likelihood for incident mobility impairment. Weakness increased likelihood of mobility impairment regardless of low lean mass. Mortality risk patterns were inconsistent. Conclusions. These findings support our cut-points for low grip strength and low ALM-to-BMI ratio as candidate criteria for clinically relevant weakness and low lean mass. Further validation in other populations and for alternate relevant outcomes is needed.

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Hand-Grip Dynamometry Predicts Future Outcomes in Aging Adults

Richard Bohannon (2008)

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Handgrip strength and mortality in older Mexican Americans.

Laura Ray, Soham Al Snih, Deborah S. Goodwin … (2002)

To examine the association between handgrip strength and mortality in older Mexican American men and women. A 5-year prospective cohort study. Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. A population-based sample of 2,488 noninstitutionalized Mexican-American men and women aged 65 and older. Maximal handgrip strength, timed walk, and body mass index were assessed at baseline during 1993/94. Self-reports of functional disability, various medical conditions, and status at follow-up were obtained. Of the baseline sample with complete data, 507 persons were confirmed deceased 5 years later. Average handgrip strength +/- standard deviation was significantly higher in men (28.4 kg +/- 9.5) than in women (18.2g +/- 6.5). Of men who had a handgrip strength less than 22.01 kg and women who had a handgrip strength less than 14 kg, 38.2% and 41.5%, respectively, were dead 5 years later. In men in the lowest handgrip strength quartile, the hazard ratio of death was 2.10 (95% confidence interval (CI) = 1.31-3.38) compared with those in the highest handgrip strength quartile, after controlling for sociodemographic variables, functional disability, timed walk, medical conditions, body mass index, and smoking status at baseline. In women in the lowest handgrip strength quartile, the hazard ratio of death was 1.76 (95%I = 1.05-2.93) compared with those in the highest handgrip strength quartile. Poorer performance in the timed walk and the presence of diabetes mellitus, hypertension, and cancer were also significant predictors of mortality 5 years later. Handgrip strength is a strong predictor of mortality in older Mexican Americans, after controlling for relevant risk factors.