The association between handgrip strength and metabolic syndrome: A large prospective Chinese cohort study

Many studies have explored the association between handgrip strength and metabolic syndrome; however, the findings are inconsistent due to the different types of indicators used to assess handgrip strength (absolute vs. relative handgrip strength). This prospective cohort study aimed to simultaneously investigate the associations of both absolute and relative handgrip strength with metabolic syndrome, and to compare the predictive abilities of these two measures among Chinese adults.

Cox proportional hazards regression models were used to analyze 15,820 participants (49.7 % men) living in Tianjin, China. Handgrip strength was measured using a handheld dynamometer. Relative handgrip strength was normalized to body weight (kg).

During the 6-year follow-up, there were 3385 incident cases of metabolic syndrome. The fully adjusted hazards ratios (95 % confidence interval) of the incidence of metabolic syndrome for increasing quartiles of relative handgrip strength were: 1.000 (reference), 0.871(0.780, 0.973), 0.675(0.602, 0.757), 0.454(0.401, 0.513) in men and 1.000 (reference), 0.830(0.714, 0.966), 0.561(0.471, 0.668), and 0.369(0.301, 0.452) in women (both P for trend <0.0001). The optimal cut-off of relative handgrip strength to predict incident metabolic syndrome was 0.563 kg/kg in men (sensitivity = 64.3 %, specificity = 55.6 %) and 0.436 kg/kg in women (sensitivity = 57.0 %, specificity = 69.3 %).

This large cohort study showed that higher relative handgrip strength, but not absolute handgrip strength, was associated with a lower risk of metabolic syndrome. Although handgrip strength may not be highly sensitive in screening for metabolic syndrome, it remains a valuable predictive tool due to its convenience, ease of measurement, and cost-effectiveness.