Association between relative handgrip strength and metabolic syndrome in Korean postmenopausal women by time since menopause

Objectives: To investigate the association between relative handgrip strength (RHGS) and metabolic syndrome (MetS) in Korean postmenopausal women, and whether this association differs by time since menopause. Methods: We conducted a cross-sectional analysis of 4,098 naturally postmenopausal women aged 45-65 years from the Korea National Health and Nutrition Examination Survey (2014-2019). RHGS was calculated as the dominant handgrip strength divided by body mass index and categorized into quartiles. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria with an Asian-specific waist circumference cutoff (≥85 cm). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) for MetS and its components across RHGS quartiles. Subgroup analyses were stratified by time since menopause (≤10 vs. >10 y). Results: Lower RHGS was significantly associated with higher odds of MetS. Compared with Q1 (reference), adjusted ORs for MetS were 0.49 (95% CI: 0.40-0.60) in Q2, 0.28 (0.22-0.34) in Q3, and 0.17 (0.13-0.21) in Q4 ( P for trend <0.001). Similar inverse gradients were observed for all MetS components. The association was stronger in women >10 years postmenopause, with OR for Q4 versus Q1 at 0.04 (0.02-0.08) compared with 0.07 (0.05-0.10) in those ≤10 years. Conclusion: Lower RHGS is independently and dose-dependently associated with increased odds of MetS, particularly among women beyond 10 years postmenopause. RHGS may serve as a simple, low-cost tool for identifying women at elevated cardiometabolic risk in later life.