Keywords
Handgrip strength
Obesity
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Abstract
Objective: To analyze factors associated with low relative handgrip strength (RHGS) in individuals with type 2 diabetes mellitus (T2DM) in Family Health Strategies (FHS) in Rio Branco, Brazil, in 2019. Methods: A cross-sectional study was conducted with individuals registered in FHS units. The expanded sample comprised 2,225 individuals. RHGS was calculated by dividing absolute handgrip strength by body mass index and categorized into tertiles. Hierarchical ordinal logistic regression was performed at a 95% significance level. Results: The highest mean RHGS was observed among individuals aged 18–39 years. The low RHGS tertile predominantly included older adults, men, White individuals, those with elementary education or less, smokers or former smokers, alcohol users, and insufficiently active individuals. Comorbidities were associated with higher odds of low strength (OR: 1.88; 95% CI: 1.01–3.54). Low RHGS was twice as likely among individuals with hypertension (OR: 2.50; 95% CI: 1.38–4.52). Individuals with obesity had nearly three times higher odds of low RHGS (OR: 2.69; 95% CI: 1.34–5.63). Conclusion: Low RHGS in individuals with T2DM is associated with comorbidities, hypertension, and obesity. Actions promoting socioeconomic conditions, health information, physical activity, and healthy eating should be prioritized.
References
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.