Key result
Lower handgrip strength linked to ~31% higher all-cause mortality per SD in type 2 diabetes.
Why the study?
To explore the associations between handgrip strength and skeletal muscle mass with all-cause and cardiovascular disease mortality risk in patients with type 2 diabetes.
Does lower handgrip strength or skeletal muscle mass increase the risk of all-cause and cardiovascular mortality in patients with type 2 diabetes?
Cohort (n=13,392)
Yes
Does lower handgrip strength or skeletal muscle mass increase the risk of all-cause and cardiovascular mortality in patients with type 2 diabetes?
Hazard Ratio: 1.31 (95% CI 1.24–1.38)
p-value: p=<.05
Lower handgrip strength is a strong, linear predictor of increased all-cause and cardiovascular mortality in patients with type 2 diabetes, whereas skeletal muscle mass shows a U-shaped relationship.
HGS may aid mortality risk stratification in T2DM; leaves open whether improving strength alters outcomes.
Aims To explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all‐cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients. Materials and Methods Data were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex‐specific analyses were conducted. Results A total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow‐up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all‐cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles ( p trend <.05). A 1 SD decrease in HGS was found to both increase the all‐cause risk (HR: 1.31 [95% CI: 1.24–1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22–1.50]) for men, and all‐cause risk (HR: 1.26 [95% CI: 1.11–1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09–1.89]) for women. There was no statistically significant trend association between SMM/height 2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height 2 showed a U‐shaped nonlinear relationship ( p nonlinear <.05). Conclusions Grip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U‐shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.
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Wei et al. (2023) conducted a cohort in type 2 diabetes (n=13,392). Decreased handgrip strength vs. Higher handgrip strength was evaluated on all-cause mortality (men, per 1 SD decrease in handgrip strength) (HR 1.31, 95% CI 1.24-1.38, p=<.05). A 1 SD decrease in handgrip strength increased all-cause mortality risk in men (HR 1.31; 95% CI 1.24-1.38) and women (HR 1.26; 95% CI 1.11-1.42) with type 2 diabetes.
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