Inverse association of grip strength with risk of incident type 2 diabetes mellitus in community-dwelling men — ASN Events
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  3. Inverse association of grip strength with risk of incident type 2 diabetes mellitus in community-dwelling men

Inverse association of grip strength with risk of incident type 2 diabetes mellitus in community-dwelling men (#218)

Joule Li 1 2 , Gary Wittert 1 , Evan Atlantis 3 , Andrew Vincent 1 , Sarah Appleton 1 2 , Zumin Shi 4 , Robert Adams 2
  1. Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
  2. The Health Observatory, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
  3. School of Nursing and Midwifery, University of Western Sydney, Sydney, New South Wales, Australia
  4. Population Research and Outcome Studies, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia

Introduction: Low grip strength is associated with T2DM in cross-sectional studies, but there are few longitudinal studies.

Objective: To examine the association between grip strength and incident T2DM.

Methods: The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) cohort study is a sample of community-dwelling men from two harmonised cohorts: the North West Adelaide Health Study (NWAHS) and the Florey Adelaide Male Ageing Study (FAMAS). Grip strength was measured as the mean of 3 dominant hand measurements with a Jamar (NWAHS) or Smedley (FAMAS) dynamometer. T2DM was defined as any of: self-report, anti-hyperglycaemic medication use in the 6 months prior to clinic visit, FPG≥7.0 mmol/L, or HbA1c≥6.5%. Age, income, physical activity, and family history were assessed by questionnaire. Waist circumference (WC) and BMI were measured clinically. The median was imputed for missing covariates (<2% missing for all covariates except physical activity; physical activity missing 6.4%).

Results: Data were available for n=1631 men not diabetic at baseline. Incident T2DM occurred in 146 men (9.0%) over a median follow-up of 4.95 (IQR 4.35-5.00) years. Baseline grip strength was inversely associated with incident T2DM (unadjusted odds ratio [OR] per 5kg of force, 0.86 [95% CI 0.79-0.94], p=0.001). This association persisted when adjusted for age, cohort (NWAHS vs. FAMAS), income, FPG, BMI, WC, physical activity, and family history of diabetes (adjusted OR 0.87 [0.78-0.97]). There were no interaction effects between grip strength and age, FPG category, or BMI, but there was an interaction between grip strength and WC≥102cm (p=0.006). The inverse association of grip strength with incident T2DM was stronger in men with WC<102cm (unadjusted OR 0.77 [0.68-0.87]) than in men with WC≥102cm (unadjusted OR 0.96 [0.85-1.08]), although the difference diminished after adjusting for age, cohort, FPG, physical activity, and family history (WC<102cm adjusted OR 0.82 [0.69-0.96], WC≥102cm adjusted OR 0.85 [0.73-0.98]). Sensitivity analyses using only complete data (n=1493) were essentially identical.

Conclusions: Lower skeletal muscle function, as measured by grip strength, was independently associated with incident T2DM. Further research on the benefits of strength training for T2DM prevention and on the potential addition of grip strength to current T2DM risk assessment is warranted.