Gender-Specific Associations of Muscle Strength With Diabetic Retinopathy in Middle-Aged and Older Chinese Adults: A...

Muscle weakness is associated with an increased risk of diabetes. However, its relationship with diabetic retinopathy (DR) in different genders remains unclear. This study aimed to investigate gender-specific associations between grip strength, lower limb function (assessed by the 30-s chair stand test, CST-30), and the prevalence of DR.

We conducted a cross-sectional analysis of 962 adults with diabetes aged 45 years or older. Participants underwent grip strength testing, a CST-30 assessment, and retinal examinations graded according to the Early Treatment DR Study (ETDRS) classification. Low grip strength was defined as less than 28 kg in men and less than 18 kg in women. Participants in the lowest two gender-specific quintiles of CST-30 scores were categorized as having reduced lower limb strength. Pearson correlation analysis was used to assess the relationship between grip strength and CST-30, and logistic regression analysis was employed to evaluate the associations with DR.

Of the 962 participants with diabetes included, 404 were men. Grip strength was significantly but only modestly correlated with CST-30 in both men and women (r = 0.278 and 0.269, respectively). Further analysis revealed that, in men, low grip strength was independently associated with higher odds of DR (odds ratio [OR] = 2.98; 95% confidence interval [CI]: 1.33-6.68; p=0.008). However, reduced lower limb strength was not related to DR. In women, low grip strength was not associated with DR; however, reduced lower limb strength was significantly associated with DR (OR = 2.26; 95% CI: 1.18-4.34; p=0.014).

Our findings suggest that in middle-aged and older Chinese adults with diabetes, DR was related to grip strength in men but to lower limb strength in women, indicating a gender-specific difference.