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 normalised 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 normalized 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 normalized 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.
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 normalised 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 normalized 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 normalized 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.
| Original language | English |
|---|---|
| Pages (from-to) | 471-478 |
| Number of pages | 9 |
| Journal | Annals of Medicine |
| Volume | 52 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 3 Sept 2020 |
Keywords
- Handgrip strength
- Type 2 diabetes
- Risk prediction
- cohort study
Access to Document
- Full-text PDF (author’s accepted manuscript)
This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Taylor and Francis at https://doi.org/10.1080/07853890.2020.1815078. Please refer to any applicable terms of use of the publisher.