June 3, 2022BMC MedicineOpen Access

Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiometabolic multimorbidity (n=493774). Intervention: Handgrip strength vs. Highest quartile (Q4) of handgrip strength. Primary outcome: Incident cardiometabolic multimorbidity (CM) (HR 1.46, 95% CI 1.34-1.60, p=<0.0001).

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Key result

Compared with the highest quartile, individuals in the lowest quartile of handgrip strength had a 46% higher risk of developing cardiometabolic multimorbidity (HR 1.46).

Why the study?

Cardiometabolic multimorbidity is an increasing concern, but predictors for its development and prognosis are poorly understood.

Does lower handgrip strength predict the development of cardiometabolic multimorbidity and all-cause mortality in adults?

Population

493,774 participants from the UK Biobank

Comparison

Lower vs higher quartiles of handgrip strength

Design

Prospective cohort study

Follow-up

Median 12.1 years

Authors

YLYanqiang LuUniversity of South China GLGuochen LiChinese Academy of Sciences PFPietro FerrariUniversité Claude Bernard Lyon 1

Discussion

Member takes

Implication

Low handgrip strength may aid multimorbidity risk stratification; leaves open whether strength interventions improve outcomes.

Study Design

Type

Cohort (n=493,774)

Multicenter

Yes

Structured PICO

Does lower handgrip strength predict the development of cardiometabolic multimorbidity and all-cause mortality in adults?

Population

493,774 community-dwelling adults aged 37-73 years from the UK Biobank, followed for a median of 12.1 years to assess the association of handgrip strength with cardiometabolic multimorbidity and mortality.

Exposure

Handgrip strength (HGS) assessed using a hydraulic hand dynamometer (evaluated as an exposure variable across quartiles)

Comparator

Highest quartile (Q4) of handgrip strength

Outcome

Cardiometabolic multimorbidity (CM) (simultaneous occurrence of at least two of type 2 diabetes, stroke, and coronary heart disease) and all-cause mortalityhard clinical

Main Result

Hazard Ratio: 1.46 (95% CI 1.34–1.6)

p-value: p=<0.0001

Lower handgrip strength is an independent predictor of developing cardiometabolic multimorbidity and is associated with higher all-cause mortality in patients who already have cardiometabolic multimorbidity.

Limitations

The UK Biobank is not fully representative of the general population
Potential unmeasured confounding factors
Survival bias, as individuals with lower handgrip strength are more likely to have died before recruitment
Handgrip strength measurement may be more affected in patients with stroke due to long-term disability
Subgroup analyses stratified by physical activity levels were post-hoc analyses
Defining outcomes by ICD-10 codes might slightly underestimate the cases of common diseases

Cite This Study

Lu et al. (2022) conducted a cohort in Cardiometabolic multimorbidity (n=493,774). Handgrip strength vs. Highest quartile (Q4) of handgrip strength was evaluated on Incident cardiometabolic multimorbidity (CM) (HR 1.46, 95% CI 1.34-1.60, p=<0.0001). Compared with the highest quartile, individuals in the lowest quartile of handgrip strength had a 46% higher risk of developing cardiometabolic multimorbidity (HR 1.46).

synapsesocial.com/papers/6a20eea4c9150832be18156e https://doi.org/10.1186/s12916-022-02389-y

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Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Associations of handgrip strength with morbidity and all-cause mortality of cardiometabolic multimorbidity

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider