Setor K Kunutsor1,2, Nzechukwu M Isiozor3, Hassan Khan4, Jari A Laukkanen3,5,6. 1. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK. 2. Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK. 3. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 4. Division of Cardiology, Emory University, Atlanta, Georgia, USA. 5. Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland. 6. Department of Medicine, Central Finland Health Care District Hospital District, Jyväskylä, Finland.
Abstract
AIMS: Evolving debate suggests that handgrip strength (HGS), a measure of muscular strength, might be associated with the risk of type 2 diabetes (T2D); however, the evidence is conflicting. Using a systematic review and meta-analysis of published observational cohort studies in general populations, we aimed to assess the association of HGS with the future risk of T2D. METHODS: Relevant studies were sought from inception until April 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Transformed or extracted relative risks (RRs) with 95% confidence intervals (CIs) comparing the top vs bottom thirds of HGS levels were pooled using random effects meta-analysis. RESULTS: A total of 10 unique observational cohort studies comprising of 177 826 participants and >5167 T2D cases were eligible. The pooled multivariable RR (95% CI) for T2D comparing the top vs bottom thirds of HGS levels was 0.73 (0.63-0.84). This association was consistent across several relevant subgroups except for evidence of effect modification by sample size (P value for meta-regression <.001): evidence of an association in smaller studies (<250 events) 0.50 (0.40-0.63), with no significant association in bigger studies (≥250 events) 0.87 (0.73-1.05). There was no evidence of small study effects using formal tests such as funnel plots and Egger's regression symmetry test. CONCLUSION: Pooled analysis of observational cohort studies suggests that HGS may be a risk indicator for T2D in the general population. The role of utilizing HGS measurements in T2D prevention strategies warrants further investigation.
AIMS: Evolving debate suggests that handgrip strength (HGS), a measure of muscular strength, might be associated with the risk of type 2 diabetes (T2D); however, the evidence is conflicting. Using a systematic review and meta-analysis of published observational cohort studies in general populations, we aimed to assess the association of HGS with the future risk of T2D. METHODS: Relevant studies were sought from inception until April 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Transformed or extracted relative risks (RRs) with 95% confidence intervals (CIs) comparing the top vs bottom thirds of HGS levels were pooled using random effects meta-analysis. RESULTS: A total of 10 unique observational cohort studies comprising of 177 826 participants and >5167 T2D cases were eligible. The pooled multivariable RR (95% CI) for T2D comparing the top vs bottom thirds of HGS levels was 0.73 (0.63-0.84). This association was consistent across several relevant subgroups except for evidence of effect modification by sample size (P value for meta-regression <.001): evidence of an association in smaller studies (<250 events) 0.50 (0.40-0.63), with no significant association in bigger studies (≥250 events) 0.87 (0.73-1.05). There was no evidence of small study effects using formal tests such as funnel plots and Egger's regression symmetry test. CONCLUSION: Pooled analysis of observational cohort studies suggests that HGS may be a risk indicator for T2D in the general population. The role of utilizing HGS measurements in T2D prevention strategies warrants further investigation.