Handgrip strength and walking pace negatively impact the incidents of diabetes mellitus among people with HIV: a prospective cohort study in China

Background We aimed to examine the associations of handgrip strength and walking pace with the risk of incident diabetes mellitus (DM) among people with HIV (PWH). Design A cohort study. Setting This study was conducted in Taizhou City Center for Disease Control and Prevention in Zhejiang Province, mainland China. Participants A total of 1916 participants (mean age 43.3±14.2 years, 77.7% male) without diagnosed or unknown DM at baseline from the Comparative HIV and Aging Research in Taizhou cohort were included. Outcome measures The primary outcome was incident DM, defined by fasting glucose >7.0 mmol/L, HbA1c concentration >6.5% or diagnosed with DM by a doctor during the period of follow-up. Results During a mean follow-up of 3.2 years, 184 incident DM cases were identified. Overall, there was a significant inverse association between both handgrip strength and walking pace with the risk of incident DM in PWH. Compared with participants with lower handgrip strength (<32.1 and <20.3 kg for males and females) or slower walking pace (<2.1 miles/hour), those with higher handgrip strength (≥32.1 and ≥20.3 kg for males and females) or faster walking pace (≥2.1 miles/hour) had a lower risk of incident DM, the adjusted HR (aHRs) (95% CI were 0.60 (0.42 to 0.85) and 0.59 (0.42 to 0.83), respectively. A higher handgrip strength and a faster walking pace were responsible for 38.0% and 39.7% of DM cases, respectively. Moreover, the lowest risk of incident DM was observed in participants with both higher handgrip strength and faster walking pace (aHR, 0.44; 95% CI 0.25 to 0.76). Conclusion Higher handgrip strength or faster walking pace was significantly associated with a reduced risk of incident DM among PWH.