Association Between Handgrip Strength and Cardiovascular Disease Risk in MASLD: A Prospective Study From UK Biobank

Area of Science:

• Cardiovascular Medicine
• Hepatology
• Metabolic Diseases
• Epidemiology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly prevalent and associated with cardiometabolic complications.
• Handgrip strength (HGS) is a recognized indicator of overall health and a predictor of mortality and morbidity.
• The relationship between HGS and cardiovascular disease (CVD) risk specifically within the MASLD population requires further investigation.

Purpose of the Study:

• To investigate the association between handgrip strength (HGS) and the incidence of cardiovascular disease (CVD) in individuals diagnosed with MASLD.
• To analyze how varying levels of HGS impact CVD risk across different subgroups of MASLD patients, including stratification by sex.
• To determine if HGS is an independent predictor of CVD in MASLD, considering factors like advanced liver fibrosis.

Main Methods:

• Utilized data from the UK Biobank cohort, including 201,563 participants.
• Assessed handgrip strength (HGS) using a hydraulic hand dynamometer.
• Defined MASLD based on hepatic steatosis (Fatty Liver Index ≥ 60) and cardiometabolic criteria; advanced liver fibrosis identified by FIB-4 score > 2.67.
• Categorized participants into non-MASLD, MASLD with high HGS, MASLD with middle HGS, and MASLD with low-HGS groups for comparative analysis of CVD incidence.

Main Results:

• Out of 75,498 individuals with MASLD, CVD event frequency increased significantly with decreasing HGS in both males and females (p < 0.001).
• Multivariate analysis revealed elevated hazard ratios (HRs) for CVD in MASLD individuals with lower HGS compared to those with high HGS.
• For males with MASLD, HRs for CVD were 1.03 (high HGS), 1.14 (middle HGS), and 1.38 (low HGS).
• For females with MASLD, HRs for CVD were 1.07 (high HGS), 1.25 (middle HGS), and 1.56 (low HGS).
• The association between decreased HGS and increased CVD risk persisted regardless of advanced liver fibrosis status (p < 0.001).

Conclusions:

• This large prospective UK Biobank study demonstrates a significant association between reduced handgrip strength and an increased risk of cardiovascular disease in individuals with MASLD.
• Lower handgrip strength serves as a potential indicator for heightened CVD risk among the MASLD population, irrespective of liver fibrosis severity.
• Findings suggest that HGS assessment could be a valuable tool in risk stratification for cardiovascular events in patients with MASLD.