Handgrip strength—A risk indicator for type 2 diabetes: Systematic review and meta‐analysis of observational cohort studies

Setor K Kunutsor*, Nzechukwu Isiozor, Hassan Khan, Jari Laukkanen

*Corresponding author for this work

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

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 >5,167 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<0.001): 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 handgrip strength measurements in T2D prevention strategies warrants further investigation.
Original languageEnglish
Article numbere3365
Number of pages10
JournalDiabetes/Metabolism Research and Reviews
Early online date16 Jun 2020
DOIs
Publication statusE-pub ahead of print - 16 Jun 2020

Keywords

  • cohort studies
  • handgrip strength
  • meta‐analysis
  • type 2 diabetes

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