Introduction
Early detection screening tools are needed to aid in preventing vascular complications
associated with type 2 diabetes. As low muscular strength is linked to increased diabetes
risk, the purpose of this study is to establish muscular strength cut points for determining
diabetes risk using a large, nationally representative U.S. sample.
Methods
Using the 2011–2012 and 2013–2014 National Health and Nutrition Examination Survey
data, 5,108 participants aged 20–80 years (68.6% aged 20–50 years; young male participants,
n=1,813, mean age=33.43 years; young female participants, n=1,692, mean age=33.39 years; older male participants, n=813, mean age=59.92 years; older female participants, n=790, mean age=60.45 years) and free of common diabetes comorbidities were included.
Muscular strength was assessed using a handgrip dynamometer and normalized by adjusting
for body weight. A logistic regression for survey data controlling for covariates
was used to determine normalized grip strength cut points. Diabetes risk was determined
using American Diabetes Association diagnostic criteria. Analyses were conducted in
the summer of 2019.
Results
Normalized grip strength significantly predicted diabetes (p=0.0332), and the cut points for detecting diabetes risk included 0.78 (young male
participants), 0.57 (young female participants), 0.68 (older male participants), and
0.49 (older female participants). The risk percentages for diabetes and estimated
rates reported for all subgroups were comparable, and the risk percentages included
6.84 (95% CI=5.32, 8.36; younger male participants), 7.49 (95% CI=5.87, 9.10; younger
female participants), 5.76 (95% CI=2.34, 9.19, older male participants), and 4.27
(95% CI=2.44, 6.10; older female participants).
Conclusions
Normalized grip strength using the cut points proposed in this paper may be a useful
screening tool for diabetes risk in apparently healthy, normotensive adults.
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Article info
Publication history
Published online: April 06, 2020
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
