Handgrip strength improves prediction of type 2 diabetes: A prospective cohort study

Setor K Kunutsor*, Ari Voutilainen, Jari A Laukkanen

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)
30 Downloads (Pure)


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.
Original languageEnglish
Pages (from-to)471-478
Number of pages9
JournalAnnals of Medicine
Issue number8
Publication statusPublished - 3 Sept 2020


  • Handgrip strength
  • Type 2 diabetes
  • Risk prediction
  • cohort study


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