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Abstract
Purpose The purpose is to investigate the association between handgrip strength (HGS) and the risk of future diabetic complications in multicountry cohorts.
Methods The association between HGS and diabetic complications was evaluated using cox models among 84 453 patients with pre-diabetes and diabetes from the UK Biobank with a 12-year follow-up. The association between HGS and longitudinal microcirculatory damage rates was assessed among 819 patients with diabetes from the Guangzhou Diabetic Eye Study (GDES) with a 3-year follow-up. Participants were divided into three age groups (<56, 56–65 and ≥65 years), and each group was further subdivided into three HGS tertiles.
Results A 5 kg reduction in HGS was associated with increased risk for all-cause mortality (women, HR=1.10, 95% CI: 1.05 to 1.14; p<0.001; men, HR=1.13, 95% CI: 1.11 to 1.15; p<0.001). Women and men in the lowest HGS group exhibited 1.6-times and 1.3–1.5-times higher risk of myocardial infarction and stroke compared with the highest HGS group. In men, there was a higher risk of developing end-stage renal disease (HR=1.83, 95% CI: 1.30 to 2.57; p=0.001), while this was not observed in women. Both sexes in the lowest HGS group had a 1.3-times higher risk of diabetic retinopathy compared with the highest HGS group. In the GDES group, individuals with the lowest HGS showed accelerated microcirculatory damage in retina (all p<0.05).
Conclusions Reduced HGS is significantly associated with a higher risk of diabetic complications and accelerated microvascular damage. HGS could serve as a practical indicator of vascular health in patients with pre-diabetes and diabetes.
- Epidemiology
- Public health
- Retina
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Footnotes
PZ and SY are joint first authors.
WC and WW are joint senior authors.
PZ and SY contributed equally.
Contributors WW and PZ designed the study and performed the statistical analysis. WW and RL interpreted data. PZ and SY interpreted the findings and drafted the manuscript. PZ, WC and WW designed and supervised the study. All authors reviewed the manuscript, edited it for intellectual content and gave final approval for this version to be published. WW are the guarantor of this work and, as such, had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was funded by the Hainan Province Clinical Medical Center, the National Natural Science Foundation of China (82371086 and 82301253), the Guangdong Basic and Applied Basic Research Foundation (2022A151511) and the China Postdoctoral Science Foundation (2022M723605).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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