Aims Evolving debate suggests that handgrip strength (HGS), a measure of muscular strength, might be associated with the risk of type 2 diabetes (T2D); however, the evidence is conflicting. Using a systematic review and meta‐analysis of published observational cohort studies in general populations, we aimed to assess the association of HGS with the future risk of T2D. Methods Relevant studies were sought from inception until April 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Transformed or extracted relative risks (RRs) with 95% confidence intervals (CIs) comparing the top vs bottom thirds of HGS levels were pooled using random effects meta‐analysis. Results A total of 10 unique observational cohort studies comprising of 177 826 participants and >5167 T2D cases were eligible. The pooled multivariable RR (95% CI) for T2D comparing the top vs bottom thirds of HGS levels was 0.73 (0.63‐0.84). This association was consistent across several relevant subgroups except for evidence of effect modification by sample size (P value for meta‐regression <.001): evidence of an association in smaller studies (<250 events) 0.50 (0.40‐0.63), with no significant association in bigger studies (≥250 events) 0.87 (0.73‐1.05). There was no evidence of small study effects using formal tests such as funnel plots and Egger's regression symmetry test. Conclusion Pooled analysis of observational cohort studies suggests that HGS may be a risk indicator for T2D in the general population. The role of utilizing HGS measurements in T2D prevention strategies warrants further investigation.
Aim To examine the association between Life’s Essential 8 (LE8) and the risk of cardiovascular and all-cause mortality. Methods The LE8 was computed for 1662 men, aged 42 to 60 years, without pre-existing history of CVD at baseline in the Kuopio Ischaemic Heart Disease study. The LE8 factors include diet, physical activity, nicotine exposure, sleep, body mass index, blood pressure, blood glucose and lipids. Each LE8 factor was scored between 0 to 100 points. The summation of all points generated the total LE8 score, which was categorized into quartiles - ≤ 420; > 420 to 485; > 485 to 550; and >550. Multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals of LE8 scores for the outcomes. Results During a median follow-up of 30 years, 402 and 987 men died from CVD and any cause, respectively. The total LE8 score among participants ranged from 185 to 750. The higher the LE8 scores, the lower the risk of dying from CVD and all-cause. Following adjustment for age, alcohol consumption and socioeconomic status, every 50-unit increase in LE8 score was associated with 17% and 14% lower risk of CVD and all-cause deaths, respectively. Men within LE8 top quartile had 60% lower risk of CVD mortality when compared with those within the bottom quartile. Conclusion Life’s Essential 8 was strongly and inversely associated with the risk of CVD death and all-cause mortality among ageing men. Measures that promote optimal LE8 scores should be encouraged among the general population.
Handgrip strength (HGS), a measure of muscular strength, might be a risk indicator for cognitive functioning, but the evidence is not consistent. Using a new prospective study and meta-analysis of published observational cohort studies, we aimed to evaluate the prospective associations of HGS with poor cognitive outcomes including cognitive impairment, dementia and Alzheimer’s disease (AD). Handgrip strength, measured using a Martin-Balloon-Vigorimeter, was assessed at baseline in a population-based sample of 852 men and women with good cognitive function in the Kuopio Ischemic Heart Disease cohort. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for cognitive outcomes. Relevant published studies were sought in MEDLINE, Embase and Web of Science from inception until October 2021 and pooled using random effects meta-analysis. During a median follow-up of 16.6 years, 229 dementia cases were recorded. Comparing extreme tertiles of HGS, the multivariable adjusted HR (95% CI) for dementia, AD and vascular dementia was 0.77 (0.55–1.07), 0.75 (0.52–1.10) and 0.49 (0.16–1.48), respectively. In a meta-analysis of 16 population-based prospective cohort studies (including the current study) comprising 180,920 participants, the pooled multivariable adjusted relative risks (95% CIs) comparing the top vs bottom thirds of HGS levels were as follows: 0.58 (0.52–0.65) for cognitive impairment; 0.37 (0.07–1.85) for cognitive decline; 0.73 (0.62–0.86) for dementia; 0.68 (0.53–0.87) for AD; and 0.48 (0.32–0.73) for vascular dementia. GRADE quality of evidence ranged from low to very low. Meta-analysis of aggregate prospective data suggests that HGS may be a risk indicator for poor cognitive outcomes such as cognitive impairment, dementia and AD. Systematic review registration: PROSPERO 2021: CRD42021237750.
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