Weakness Status is Differentially Associated with Time to Diabetes in Americans

Overview

Journal Adv Geriatr Med Res

Date 2024 Aug 9

PMID 39119102

Authors

Kelly Knoll

Yeong Rhee

Natasha Fillmore

Donald A Jurivich

Justin J Lang

Brenda M McGrath

Grant R Tomkinson

Ryan McGrath

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate the associations of (1) individual absolute and body size normalized weakness cut-points, and (2) the collective weakness classifications on time to diabetes in Americans.

Methods: We analyzed data from 9577 adults aged at least 50-years from the Health and Retirement Study. Diabetes diagnosis was self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males with HGS <35.5 kg (absolute), <0.45 kg/kg (normalized to body weight), or <1.05 kg/kg/m (normalized to BMI) were categorized as weak. Females were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg/kg/m. Compounding weakness included falling below 1, 2, or all 3 cut-points.

Results: Persons below the body weight normalized weakness cut-points had a 1.29 (95% confidence interval (CI): 1.15-1.47) higher hazard for incident diabetes, while those below the BMI normalized cut-points had a 1.30 (CI: 1.13-1.51) higher hazard. The association between absolute weakness and incident diabetes was insignificant (hazard ratio: 1.06; CI: 0.91-1.24). Americans below 1, 2, or all 3 collective weakness categories had a 1.28 (CI: 1.10-1.50), 1.29 (CI: 1.08-1.52), and 1.33 (CI: 1.09-1.63) higher hazard for the incidence of diabetes, respectively.

Conclusions: Our findings indicate that while absolute weakness, which is confounded by body size, was not associated with time to diabetes, adjusting for the influence of body size by normalizing HGS to body weight and BMI was significantly associated with time to diabetes. This suggests that muscle strength, not body size, may be driving such associations with time to diabetes.

References

Peterson M, McGrath R, Zhang P, Markides K, Al Snih S, Wong R . Muscle Weakness Is Associated With Diabetes in Older Mexicans: The Mexican Health and Aging Study. J Am Med Dir Assoc. 2016; 17(10):933-8. PMC: 5039066. DOI: 10.1016/j.jamda.2016.06.007. View

Donini L, Busetto L, Bischoff S, Cederholm T, Ballesteros-Pomar M, Batsis J . Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts. 2022; 15(3):321-335. PMC: 9210010. DOI: 10.1159/000521241. View

Lamarca R, Alonso J, Gomez G, Munoz A . Left-truncated data with age as time scale: an alternative for survival analysis in the elderly population. J Gerontol A Biol Sci Med Sci. 1998; 53(5):M337-43. DOI: 10.1093/gerona/53a.5.m337. View

McGrath R, Cawthon P, Clark B, Fielding R, Lang J, Tomkinson G . Recommendations for Reducing Heterogeneity in Handgrip Strength Protocols. J Frailty Aging. 2022; 11(2):143-150. DOI: 10.14283/jfa.2022.21. View

McGrath R, Tomkinson G, Hamm J, Juhl K, Knoll K, Parker K . The Role of Different Weakness Cut-Points for Future Cognitive Impairment in Older Americans. J Am Med Dir Assoc. 2023; 24(12):1936-1941.e2. PMC: 10840802. DOI: 10.1016/j.jamda.2023.07.021. View

Bauer M, Kirchner J . Implementation science: What is it and why should I care?. Psychiatry Res. 2019; 283:112376. DOI: 10.1016/j.psychres.2019.04.025. View

Feng X, Croteau K, Kolt G, Astell-Burt T . Does retirement mean more physical activity? A longitudinal study. BMC Public Health. 2016; 16:605. PMC: 4955250. DOI: 10.1186/s12889-016-3253-0. View

Brown E, Buchan D, Madi S, Gordon B, Drignei D . Grip Strength Cut Points for Diabetes Risk Among Apparently Healthy U.S. Adults. Am J Prev Med. 2020; 58(6):757-765. DOI: 10.1016/j.amepre.2020.01.016. View

Peterson M, Zhang P, Choksi P, Markides K, Al Snih S . Muscle Weakness Thresholds for Prediction of Diabetes in Adults. Sports Med. 2016; 46(5):619-28. PMC: 4863981. DOI: 10.1007/s40279-015-0463-z. View

10.

Boonpor J, Parra-Soto S, Petermann-Rocha F, Ferrari G, Welsh P, Pell J . Associations between grip strength and incident type 2 diabetes: findings from the UK Biobank prospective cohort study. BMJ Open Diabetes Res Care. 2021; 9(1). PMC: 8344322. DOI: 10.1136/bmjdrc-2020-001865. View

11.

Manda C, Hokimoto T, Okura T, Isoda H, Shimano H, Wagatsuma Y . Handgrip strength predicts new prediabetes cases among adults: A prospective cohort study. Prev Med Rep. 2020; 17:101056. PMC: 7016270. DOI: 10.1016/j.pmedr.2020.101056. View

12.

Bhasin S, Travison T, Manini T, Patel S, Pencina K, Fielding R . Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020; 68(7):1410-1418. DOI: 10.1111/jgs.16372. View

13.

McGrath R, Johnson N, Klawitter L, Mahoney S, Trautman K, Carlson C . What are the association patterns between handgrip strength and adverse health conditions? A topical review. SAGE Open Med. 2020; 8:2050312120910358. PMC: 7052448. DOI: 10.1177/2050312120910358. View

14.

Cai L, Gonzales T, Wheeler E, Kerrison N, Day F, Langenberg C . Causal associations between cardiorespiratory fitness and type 2 diabetes. Nat Commun. 2023; 14(1):3904. PMC: 10318084. DOI: 10.1038/s41467-023-38234-w. View

15.

McGrath R . Comparing absolute handgrip strength and handgrip strength normalized to body weight in aging adults. Aging Clin Exp Res. 2019; 31(12):1851-1853. DOI: 10.1007/s40520-019-01126-5. View

16.

Mesinovic J, Zengin A, de Courten B, Ebeling P, Scott D . Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes Metab Syndr Obes. 2019; 12:1057-1072. PMC: 6630094. DOI: 10.2147/DMSO.S186600. View

17.

. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023; 402(10397):203-234. PMC: 10364581. DOI: 10.1016/S0140-6736(23)01301-6. View

18.

Khunti K, Chudasama Y, Gregg E, Kamkuemah M, Misra S, Suls J . Diabetes and Multiple Long-term Conditions: A Review of Our Current Global Health Challenge. Diabetes Care. 2023; 46(12):2092-2101. PMC: 10698221. DOI: 10.2337/dci23-0035. View

19.

Fisher G, Ryan L . Overview of the Health and Retirement Study and Introduction to the Special Issue. Work Aging Retire. 2018; 4(1):1-9. PMC: 5798643. DOI: 10.1093/workar/wax032. View

20.

Albers P, Pedersen A, Birk J, Kristensen D, Vind B, Baba O . Human muscle fiber type-specific insulin signaling: impact of obesity and type 2 diabetes. Diabetes. 2014; 64(2):485-97. DOI: 10.2337/db14-0590. View