Low grip strength flags high CVD risk in diabetes patients
medwireNews: Low grip strength may identify people with diabetes who are at particularly high risk for cardiovascular disease (CVD), UK research suggests.
The study found that the elevated risk for CVD and death from CVD seen in patients with diabetes was limited to those with low grip strength, which was used as a proxy measure of muscular strength.
Among people with high grip strength, those with diabetes were not at significantly increased risk for CVD compared with those without diabetes, although they were at greater risk for all-cause mortality.
The researchers say: “These data have implications for public health policies and indicate that in people with diabetes, targeting interventions at those with low grip strength may have a greater impact.”
The findings come from 347,130 participants enrolled in the UK Biobank, a large population cohort study including individuals aged 40 to 69 years, of whom 13,373 (4.0%) had diabetes. The mean age of participants was 55.9 years, and 54.2% were women.
Low grip strength ranged from <23 to <18 kg in women, depending on age, compared with a high grip strength of >23 to >28 kg. The corresponding ranges for men were <33 to <38 versus >39 to >46 kg.
During a median follow-up of 4.9 years, 4301 participants developed CVD and 6209 participants died, 594 as a result of CVD.
Participants with diabetes were at higher risk for CVD and both all-cause and CVD mortality than those without diabetes, the UK researchers report in Diabetes Care.
Compared with individuals without diabetes and high grip strength, diabetes patients with low grip strength had a significantly higher risk for CVD incidence and all-cause and CVD mortality, with corresponding hazard ratios of 2.19, 2.79, and 4.05.
But participants with diabetes and high grip strength were only at significantly higher risk for all-cause mortality than their peers without diabetes (HR=1.36).
Stuart Gray and colleagues, from the University of Glasgow, report: “The current data demonstrate that a low grip strength is associated with further elevations in the already high risk of all-cause mortality, CVD incidence, and CVD mortality in people with diabetes.”
They add: “The findings suggest that grip strength has clinical utility in identifying people with diabetes at risk for poor health outcomes.
“Furthermore, targeting interventions such as resistance exercise to people with low grip strength in whom the greatest benefits may be gained could increase clinical effectiveness. These conclusions remain to be tested in future well-designed randomized controlled trials.”
By Anita Chakraverty
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