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Combined handgrip strength and incident chronic digestive diseases: a prospective parallel analysis examining broad
Jian Liu1, Minghao Ji1, Xinlong Pang1
1Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China.
Background:
Handgrip strength is a simple marker of muscle function, but its prospective association with digestive morbidity remains unclear.
Objective:
To examine the association between combined handgrip strength (CHS) and incident self-reported digestive outcomes in two ageing cohorts with different endpoint definitions.
Methods:
This prospective parallel analysis included 7,750 participants from CHARLS (2011-2018) and 6,728 from SHARE (2011-2017), after excluding individuals with baseline digestive diseases. CHS was the sum of the maximum grip strength values from both hands. Outcomes were incident chronic digestive system diseases in the China Health and Retirement Longitudinal Study (CHARLS) and incident peptic ulcer disease in the Survey of Health, Ageing and Retirement in Europe (SHARE), based on self-reported physician diagnoses. Cox proportional hazards models were used, with sensitivity analyses using shorter follow-up windows and maximum single-hand grip strength.
Results:
In CHARLS, higher CHS was associated with lower risk of incident chronic digestive system diseases in the fully adjusted model (HR per 1 kg increase, 0.990; 95% CI, 0.984-0.997), and the high-CHS group had lower risk than the low-CHS group (HR, 0.895; 95% CI, 0.803-0.998). In SHARE, the overall association with peptic ulcer disease was weaker and non-significant (HR, 0.996; 95% CI, 0.991-1.001), whereas an inverse association was observed among women (HR, 0.989; 95% CI, 0.979-0.999). Sensitivity analyses were generally directionally consistent.
Conclusions:
Lower CHS was associated with subsequent self-reported digestive outcomes, more consistently in CHARLS than in SHARE. Outcome heterogeneity, self-reported diagnoses, modest discriminatory performance, and unmeasured confounding warrant cautious interpretation.