Resumen
Objetivo: Analizar los factores asociados con la baja fuerza de prensión manual relativa (FPMr) en personas con diabetes mellitus tipo 2 (DM2) en las Estrategias de Salud de la Familia (ESF) de Rio Branco, Brasil, en 2019. Métodos: Estudio transversal realizado con personas registradas en las ESF. La muestra expandida estuvo constituida por 2.225 individuos. La FPMr se calculó dividiendo la fuerza de prensión manual absoluta por el índice de masa corporal y se categorizó en terciles. Se realizó una regresión logística ordinal jerárquica con un nivel de significancia del 95%. Resultados: La mayor media de FPMr se observó en personas de 18 a 39 años. En el tercil de baja FPMr predominaron personas mayores, hombres, de raza blanca, con educación primaria o inferior, fumadoras o exfumadoras, consumidoras de alcohol e insuficientemente activas. Las comorbilidades se asociaron con mayor probabilidad de baja fuerza (OR: 1,88; IC del 95%: 1,01–3,54). La baja FPMr fue dos veces más probable en personas con hipertensión (OR: 2,50; IC del 95%: 1,38–4,52). Las personas con obesidad presentaron casi tres veces más probabilidades de baja FPMr (OR: 2,69; IC del 95%: 1,34–5,63). Conclusión: La baja FPMr en personas con DM2 se asocia con comorbilidades, hipertensión y obesidad. Deben priorizarse acciones de promoción de la actividad física y alimentación saludable.
Referencias
AMERICAN DIABETES ASSOCIATION (ADA). Standards of Medical Care in Diabetes – 2019. Diabetes Care, 2019; 42(Suppl 1): S13-S28.
AL-OZAIRI E, et al. Skeletal Muscle and Metabolic Health: How Do We Increase Muscle Mass and Function in People with Type 2 Diabetes? The Journal of Clinical Endocrinology & Metabolism, 2021; 106(Suppl 2): 309-317.
AMARAL CA, et al. Associação da força de preensão manual com morbidades referidas em adultos de Rio Branco, Acre, Brasil: estudo de base populacional. Cadernos de Saúde Pública, 2015; 31(6): 1313-1325.
BERTOVIC DA, et al. Muscular strength training is associated with low arterial compliance and high pulse pressure. Hypertension, 1999; 33(6): 1385-1391.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde e Ambiente. Vigitel Brasil 2023: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde, 2023.
CAVAZZOTTO TG, et al. Desempenho em testes de força estática: comparação entre trabalhadores hipertensos e normotensos. Revista da Associação Médica Brasileira, 2012; 58(5): 574-579.
CHEN CN, et al. Factors associated with relative muscle strength in patients with type 2 diabetes mellitus. Archives of Gerontology and Geriatrics, 2021; 95: 104384.
CHEUNG CL, et al. Association of handgrip strength with chronic diseases and multimorbidity: a cross-sectional study. AGE, 2013; 35(3): 929-941.
CUTHBERTSON DJ, et al. Dynapenic obesity and the risk of incident Type 2 diabetes: the English Longitudinal Study of Ageing. Diabetic Medicine, 2015; 33(8): 1052-1059.
DIAS JA, et al. Força de preensão palmar: métodos de avaliação e fatores que influenciam a medida. Revista Brasileira de Cineantropometria e Desempenho Humano, 2011; 12(3): 209-216.
DIAS VN, et al. Palmar strength and sociodemographic, clinical-functional, and psycho-cognitive factors in elderly with Diabetes Mellitus. Fisioterapia em Movimento, 2019; 32: e003223.
FALUDI A, et al. Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017. Arquivos Brasileiros de Cardiologia, 2017; 109(2): 1-91.
FAN H, et al. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Scientific Reports, 2016; 6: 21521.
FESS EE. Documentation: essential elements of an upper extremity assessment battery. In: MACKIN E, et al. Rehabilitation of the hand and upper extremity. 5 ed. St. Louis: CV Mosby, 2002; 263-284.
GONÇALVES A, ALVES LC. Regional inequalities in Brazil and new approaches to measuring population aging. Cadernos de Saúde Pública, 2026; 42: e00217725.
HAMASAKI H, et al. Association of handgrip strength with hospitalization, cardiovascular events, and mortality in Japanese patients with type 2 diabetes. Scientific Reports, 2017; 7(1): 7041.
HAMASAKI H, YANAI H. Handgrip strength is inversely associated with augmentation index in patients with type 2 diabetes. Scientific Reports, 2023; 13(1): 1125.
HAN Y e KIM YS. Relative Grip Strength and Muscle-Strengthening Activity: Independent and Joint Associations with Type 2 Diabetes Mellitus. Journal of Obesity & Metabolic Syndrome, 2025; 34(2): 148-157.
HASKELL WL, et al. Physical Activity and Public Health: Updated Recommendation for Adults from the American College of Sports Medicine and the American Heart Association. Medicine & Science in Sports & Exercise, 2007; 39(8): 1423-1434.
KALINKOVICH A, LIVSHITS G. Sarcopenic obesity or obese sarcopenia: a cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis. Ageing Research Reviews, 2017; 35: 200-221.
KAMINSKY LA. Manual do ACSM para avaliação da aptidão física relacionada à saúde. 3 ed. Rio de Janeiro: Guanabara Koogan, 2000.
KIM JA, et al. Impact of Muscle Quality on Muscle Strength and Physical Performance Beyond Muscle Mass or Diabetes Status. Journal of Cachexia, Sarcopenia and Muscle, 2025; 16(2): e13760.
LAWMAN HG, et al. Associations of Relative Handgrip Strength and Cardiovascular Disease Biomarkers in U.S. Adults, 2011-2012. American Journal of Preventive Medicine, 2016; 50(6): 677-683.
MALACHIAS M, et al. 7ª Diretriz Brasileira de Hipertensão Arterial. Arquivos Brasileiros de Cardiologia, 2016; 107(3): 1-83.
MASLOW AL, et al. Muscular Strength and Incident Hypertension in Normotensive and Prehypertensive Men. Medicine & Science in Sports & Exercise, 2010; 42(2): 288-295.
PARK DY, et al. Comparison of Absolute and Relative Grip Strength to Predict Incidence of Diabetes Mellitus in Korea: A Prospective Cohort Study. Metabolic Syndrome and Related Disorders, 2024; 22(6): 463-470.
REIS RCPD, et al. Evolution of diabetes in Brazil: prevalence data from the 2013 and 2019 Brazilian National Health Survey. Cadernos de Saúde Pública, 2022; 38(Suppl 1): e00149321.
ROHM TV, et al. Inflammation in obesity, diabetes, and related disorders. Immunity, 2022; 55(1): 31-55.
SOCIEDADE BRASILEIRA DE DIABETES (SBD). Diretrizes da Sociedade Brasileira de Diabetes: 2019-2020. São Paulo: Clannad, 2019.
SCHMIDT MI, et al. Chronic non-communicable diseases in Brazil: burden and current challenges. The Lancet, 2011; 377(9781): 1949-1961.
SILVA BARBOSA FS, et al. Associação entre força muscular relativa e risco cardiometabólico em pacientes hipertensos. Nutrición Clínica y Dietética Hospitalaria, 2018; 38(1): 165-169.
STUMP CS, et al. The metabolic syndrome: role of skeletal muscle metabolism. Annals of Medicine, 2006; 38(6): 389-402.
TOMKINSON GR, et al. International norms for adult handgrip strength: a systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions. Journal of Sport and Health Science, 2024; 14: 101014.
VAISHYA R, et al. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. Journal of Health, Population and Nutrition, 2024; 43(1): 7.
VOLAKLIS KA, et al. Handgrip strength is inversely and independently associated with multimorbidity among older women: results from the KORA-Age study. European Journal of Internal Medicine, 2016; 31: 35-40.
WANG Y, et al. Association of Muscular Strength and Incidence of Type 2 Diabetes. Mayo Clinic Proceedings, 2019; 94(4): 643-651.
WORLD HEALTH ORGANIZATION (WHO). Global recommendations on physical activity for health. Geneva: WHO, 2010.
WORLD HEALTH ORGANIZATION (WHO). Medication Safety in Polypharmacy. Geneva: WHO, 2019.
WORLD HEALTH ORGANIZATION (WHO). Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: WHO, 2000.
YOUSIEF E, et al. Association of handgrip strength and CT-derived body composition with insulin resistance in women with prediabetes and newly diagnosed type 2 diabetes. Archives of Endocrinology and Metabolism, 2026: 1-7.
