Setor K Kunutsor1,2, Ari Voutilainen3, Jari A Laukkanen3,4,5. 1. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the 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. Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland. 5. Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland.
Abstract
PURPOSE: We aimed to determine whether handgrip strength (HGS)improves type 2 diabetes (T2D) risk prediction beyond conventional risk factors. DESIGN: Handgrip strength was assessed at baseline in 776 individuals aged 60-72 years without a history of T2D in a prospective cohort. Handgrip strength was normalized to account for the effect of body weight. Hazard ratios (HRs) (95% confidence intervals [CI]) and measures of risk discrimination for T2D and reclassification [net reclassification improvement (NRI), integrated discrimination index (IDI)] were assessed. RESULTS: During 18.1 years median follow-up, 59 T2D events were recorded. The HR (95% CI)for T2D adjusted for conventional risk factors was 0.49 (0.31-0.80) per 1 standard deviation higher normalised HGS and was 0.54 (0.31-0.95) and 0.53 (0.29-0.97) on adjustment for risk factors in the DESIR and KORA S4/F4 prediction models, respectively. Adding normalised HGS to these risk scores was associated with improved risk prediction as measured by differences in -2 log likelihood, NRI and IDI. Sex-specific HRs and risk prediction findings using sensitive measures suggested the overall results were driven by those in women. CONCLUSION: Adding measurements of HGS to conventional risk factors might improve T2D risk assessment, especially in women. Further evaluation is needed in larger studies. KEY MESSAGES Handgrip strength (HGS) is independently associated with reduced risk of type 2 diabetes (T2D), but its utility in classifying or predicting T2D risk has not been explored. In this prospective cohort study of older Caucasian men and women, adding measurements of HGS to conventional risk factors improved T2D risk assessment, especially in women. Assessment of HGS is simple and inexpensive and could prove a valuable clinical tool in the early identification of people at high risk of future T2D.
PURPOSE: We aimed to determine whether handgrip strength (HGS)improves type 2 diabetes (T2D) risk prediction beyond conventional risk factors. DESIGN: Handgrip strength was assessed at baseline in 776 individuals aged 60-72 years without a history of T2D in a prospective cohort. Handgrip strength was normalized to account for the effect of body weight. Hazard ratios (HRs) (95% confidence intervals [CI]) and measures of risk discrimination for T2D and reclassification [net reclassification improvement (NRI), integrated discrimination index (IDI)] were assessed. RESULTS: During 18.1 years median follow-up, 59 T2D events were recorded. The HR (95% CI)for T2D adjusted for conventional risk factors was 0.49 (0.31-0.80) per 1 standard deviation higher normalised HGS and was 0.54 (0.31-0.95) and 0.53 (0.29-0.97) on adjustment for risk factors in the DESIR and KORA S4/F4 prediction models, respectively. Adding normalised HGS to these risk scores was associated with improved risk prediction as measured by differences in -2 log likelihood, NRI and IDI. Sex-specific HRs and risk prediction findings using sensitive measures suggested the overall results were driven by those in women. CONCLUSION: Adding measurements of HGS to conventional risk factors might improve T2D risk assessment, especially in women. Further evaluation is needed in larger studies. KEY MESSAGES Handgrip strength (HGS) is independently associated with reduced risk of type 2 diabetes (T2D), but its utility in classifying or predicting T2D risk has not been explored. In this prospective cohort study of older Caucasian men and women, adding measurements of HGS to conventional risk factors improved T2D risk assessment, especially in women. Assessment of HGS is simple and inexpensive and could prove a valuable clinical tool in the early identification of people at high risk of future T2D.
Entities:
Keywords:
Handgrip strength; cohort study; risk prediction; type 2 diabetes
Authors: Francesco Zaccardi; Gary O'Donovan; David R Webb; Thomas Yates; Sudhir Kurl; Kamlesh Khunti; Melanie J Davies; Jari A Laukkanen Journal: Atherosclerosis Date: 2015-09-11 Impact factor: 5.162
Authors: Hong Xu; Sara Garcia-Ptacek; Martin Annetorp; Annette Bruchfeld; Tommy Cederholm; Peter Johnson; Miia Kivipelto; Carina Metzner; Dorota Religa; Maria Eriksdotter Journal: J Nephrol Date: 2021-03-22 Impact factor: 3.902