Handgrip Strength as a Predictor of Nutritional Status in Chinese Elderly Inpatients at Hospital Admission

Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.

Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies

Purpose:The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.Methods:An umbrella review of systematic reviews with meta-analyses of observational studies was conducted.We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values,95%prediction intervals,heterogeneity,small-study effects,and excess significance.We graded the evidence from convincing(Class I)to weak(Class IV).Results:From 504 articles returned in a search of the literature,8 systematic reviews were included in our review,with a total of 11 outcomes.Overall,nine of the 11 of the outcomes reported nominally significant summary results(p<0.05),with 4 associations surviving the application of the more stringent p value(p<106).No outcome presented convincing evidence.Three associations showed Class II evidence(i.e.,highly suggestive):(1)higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population(n=34 studies;sample size=1,855,817;relative risk=0.72,95%confidence interval(95%CI):0.670.78),(2)cardiovascular death risk in mixed populations(n=15 studies;relative risk=0.84,95%CI:0.780.91),and(3)incidence of disability(n=7 studies;relative risk=0.76,95%CI:0.660.87).Conclusion:The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality,as well as disability.To further inform intervention strategies,future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.

Associations of Sarcopenia, Handgrip Strength and Calf Circumference with Cognitive Impairment among Chinese Older Adults

Objective To evaluate the associations of sarcopenia,handgrip strength and calf circumference with cognitive impairment among Chinese older adults.Methods Totally 2,525 older adults were recruited from the Healthy Aging and Biomarkers Cohort Study.Cognitive impairment was assessed by the Chinese Mini-Mental State Examination.Handgrip strength was calculated from the means of the right and left hand values.Calf circumference was measured at the site of maximum circumference of the non-dominant leg.The formula developed by Ishii was used to define sarcopenia.Multiple logistic regression was performed to evaluate the associations of sarcopenia,handgrip strength,and calf circumference with cognitive impairment.Results The prevalence of cognitive impairment was 34.36%.The adjusted odds ratio(OR)for cognitive impairment in individuals with sarcopenia was 2.55[95% confidence interval(95%CI):1.86-3.50].Compared with individuals in the first quartile(Q1)of calf circumference,the adjusted ORs in the second,third,and fourth quartiles(Q_(2),Q_(3),and Q_(4))were 0.75(95% CI:0.58-0.96),0.59(95% CI:0.44-0.79),and 0.62(95% CI:0.45-0.8),respectively.Compared with individuals in Q1 of handgrip strength,the adjusted ORs for Q_(2),Q_(3),and Q_(4) were 0.49(95%CI:0.38-0.62),0.31(95% CI:0.23-0.41),and 0.30(95%CI:0.21-0.44),respectively.Conclusion Sarcopenia,identified by low handgrip strength and low calf circumference,was positively associated with cognitive impairment.

Handgrip strength and falls in community-dwelling Egyptian seniors

Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Methods: History of falls in the past year and their number as well as GS measurement in both hands using Baseline? pneumatic squeeze handheld dynamometer. Results: There is a highly significant difference between the GS of fallers and non-fallers in both hands (P = 0.000). There is a highly significant negative correlation between the mean GS and the number of falls (P = 0.003). There is a highly significant positive correlation between GS of the right hand with the number of falls (R = 0.226, P = 0.009), as for the correlation with the left GS it was a weaker positive correlation (R = 0.209, P = 0.16). Conclusion: Seniors with history of falls have a lower GS in both dominant and nondominant hands and it is directly related to the number of falls. GS is decreased in senior fallers even if within the normal range.

Handgrip exercise elevates basilic venous hemodynamic parameters in healthy subjects

Purpose:This study examined the effect of handgrip exercise on hemodynamic indices to determine the most effective regimen for promoting blood circulation.Methods:Healthy individuals were divided into three treatment groups with each performing exercises using an electronic handgrip.Groups performed exercises to determine the most appropriate tap position,frequency,and duration.The hemodynamic indices were measured by Doppler ultrasound.Results:The best handgrip position was the weak tap position.Venous blood flow velocity and blood flow increased significantly with each exercise relative to the resting state(p<0.01).Venous blood flow velocity and blood flow peaked with handgrip exercise frequency of 25 times/min for 2 min(p<0.01).No significant differences were observed between sexes.Conclusion:Handgrip exercise is an effective method for improving blood circulation in the upper extremities.

Relationships of Handgrip Strength with Menstruation-Related Symptoms in Female University Students in Japan

Introduction: Some somatic and psychological disorders have been associated with handgrip strength, which is an easy, inexpensive and noninvasive method for assessment of muscle strength. We conducted a cross-sectional study to clarify the relationship of handgrip strength and menstruation-related symptoms. Material and Methods: Handgrip strength was measured and a self-administered questionnaire was performed in female university students in Japan. Results: Handgrip strength did not significantly differ among the menstrual phases. The mean handgrip strength level (n = 260) was 26.0 ± 3.9 kg. We divided the subjects into three groups according to the handgrip strength level. Handgrip strength was associated with degrees of depression and anxiety during menstruation. Conclusion: This can be used as fundamental data in further clarifying the relationship between muscle strength and menstruation-related symptoms.

The association of handgrip strength with prevalence of hypertension among Chinese Han population

Objective To investigate the associations of handgrip strength with hypertension among Chinese Han population.Methods A total of 11, 151 subjects were recruited between October to November in 2015, using a multi-stage sampling method in 13 townships of Jurong city, Jiangsu Province, south of China.

Gender differences and laterality in maximal handgrip strength and controlled force exertion in young adults

This study examines gender differences and laterality in maximal handgrip strength and controlled force exertion (CFE) in young adults. The subjects were 75 healthy young males (mean age 19.6 ± 1.6 yrs.) and 50 healthy young females (mean age 20.9 ± 1.9 yrs.). Maximal handgrip strength was measured twice. The subjects performed the CFE test three times after one practice trial. They matched their handgrip strengths to the demand values, which constantly changed and ranged from 5 to 25% of maximal handgrip strength. The difference between the demand value and the grip exertion value was used as an estimate of CFE. Maximal handgrip strength was significantly larger in males than in females in both the dominant and non-dominant hands, and was significantly larger in the dominant hand in both males and females. Insignificant gender differences were found in CFE of both hands. CFE was significantly superior in the dominant hand in both genders. In conclusions, gender differences are present in maximal handgrip strength of the dominant and non-dominant hands in young adults, but not in CFE of both hands. Laterality exists in maximal handgrip strength and in CFE for both genders.

Intervention study of finger-movement exercises and finger weight-lift training for improvement of handgrip strength among the very elderly

Objectives:To examine the effects of finger-movement exercises and finger weight-lift training on handgrip strength and Activities of Daily Living Scale(ADLS)values.Methods:A total of 80 very elderly adults(aged
80 years)were assigned to either an intervention group(n?40)or a control group(n?40).Subjects in the intervention group performed finger-movement exercises and weight-lift training for a period of 3 months,while subjects in the control group received no intervention,and were unaware of the interventions received in the other group.Results:After completing 3 months of finger-movement exercises and weight-lift training,the average handgrip strength of the 40 participants in the intervention group had increased by 2.1 kg,whereas that in the control group decreased by 0.27 kg(P<0.05).After receiving intervention,the number of subjects in the intervention group with an ADLS score>22 points decreased by 7.5%(P<0.05,vs.pre-intervention).Conclusions:The combined use interventionwith finger-movement exercises and proper finger weight-lift training improved the handgrip strength andADLS values of very elderly individuals.These rehabilitation exercisesmay be used to help the elderlymaintain their self-care abilities.

Associations between Sensitivity to Cold, Menstruation-Related Symptoms and Handgrip Strength in Female University Students in Japan

Sensitivity to cold, which is a popular symptom in Japanese women, is associated with various symptoms such as shoulder stiffness and general fatigue. However, an association of sensitivity to cold with muscle strength has not been reported. The aim of the study was to clarify the associations of sensitivity to cold with handgrip strength and with menstruation-related symptoms in female university students in Japan. We recruited 278 female university students in Japan. Sensitivity to cold and menstruation-related symptoms including physical and psychological symptoms were assessed by using a self-administered questionnaire that we designed. Handgrip strength was measured by using a handgrip strength dynamometer. We received responses from 269 students. The prevalence rate of sensitivity to cold in the subjects was 54.3%. The students who had sensitivity to cold had a lower handgrip strength level (25.5 ± 3.8 kg) than did the students who did not have sensitivity to cold (26.7 ± 3.9 kg) (p = 0.017). Sensitivity to cold was associated with low body mass index. In addition, the students who had sensitivity to cold tended to have low back pain and constipation during menstruation. In conclusion, sensitivity to cold is an important symptom associated with muscle strength as well as menstruation-related symptoms for young women.

The Correlation Analysis of NRS 2002,Patient-generated Subjective Global Assessment,Prealbumin,Transferrin,and Handgrip Strength in Nutritional Screening and Evaluation in Patients with Gastric Cancer

Objective The present study was designed to explore the correlations between prealbumin(PA),transferrin(TF),handgrip strength and nutrition risk screening tool 2002(NRS 2002),patient-generated subjective global assessment(PG-SGA)in preoperative nutritional screening and evaluation in gastric cancer patients.Methods 132 cases of gastric cancer patients undergoing surgical treatment from May 2015 to January 2018 were screened and evaluated by NRS 2002 and PG-SGA within 48 h after admission,and the PA,TF and handgrip strength were measured for each patient.Results The levels of PA,TF,and handgrip strength in the nutritional risk group(NRS 2002≥3)and the malnutrition group(PG-SGA≥4)were significantly lower than that in non-nutrition risk group(NRS 2002<3)and non-malnutrition group(PG-SGA<4).The levels of PA,TF,and handgrip strength of preoperative patients were negatively correlated with NRS 2002 and PG-SGA scores(P<0.05).NRS 2002 and PG-SGA scores were positively correlated(r=0.712,P<0.01).Conclusion The preoperative nutritional risk and malnutrition rate in patients with gastric cancer are high.The combined application of PA,TF,handgrip strength,NRS 2002,and PG-SGA is more helpful for nutritional screening and assessment in gastric cancer patients.

Handgrip strength in type 2 diabetics and nondiabetics:A comparative cross-sectional study among adults in rural Mysore

Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and HGS among diabetic patients.Materials and Methods:A community-based cross-sectional study was conducted in rural Mysore,India,for 4 months.Fifty-eight clinically diagnosed type 2 diabetics and 58 nondiabetics participated in the study.The handheld dynamometer was used to test the HGS of all subjects in their dominant hand.Independent t-test was used to analyze the differences in HGS between patients with and without diabetes.Results:The mean dynamometer reading among diabetics was 19.08±7.51,whereas that in nondiabetics was 27.474±13.11.There was a significant difference in HGSs between diabetics and nondiabetics(P<0.01).Conclusion:Decreased muscle strength and quality in the upper extremities are associated with type 2 diabetes and can lead to functional and physical limitations.Diabetic patients’HGS should be evaluated promptly to identify any disabilities and plan for appropriate therapy.

Correlation between Combined Urinary Metal Exposure and Grip Strength under Three Statistical Models:A Cross-sectional Study in Rural Guangxi

Objective This study aimed to investigate the potential relationship between urinary metals copper(Cu),arsenic(As),strontium(Sr),barium(Ba),iron(Fe),lead(Pb)and manganese(Mn)and grip strength.Methods We used linear regression models,quantile g-computation and Bayesian kernel machine regression(BKMR)to assess the relationship between metals and grip strength.Results In the multimetal linear regression,Cu(β=−2.119),As(β=−1.318),Sr(β=−2.480),Ba(β=0.781),Fe(β=1.130)and Mn(β=−0.404)were significantly correlated with grip strength(P<0.05).The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was−1.007(95%confidence interval:−1.362,−0.652;P<0.001)when each quartile of the mixture of the seven metals was increased.Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength,with Cu,As and Sr being negatively associated with grip strength levels.In the total population,potential interactions were observed between As and Mn and between Cu and Mn(P_(interactions) of 0.003 and 0.018,respectively).Conclusion In summary,this study suggests that combined exposure to metal mixtures is negatively associated with grip strength.Cu,Sr and As were negatively correlated with grip strength levels,and there were potential interactions between As and Mn and between Cu and Mn.

维持性血液透析患者血清25羟维生素D水平与握力和捏力的相关性分析

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清25羟维生素D[25(OH)D]水平与握力(handgrip strength,HGS)和捏力(pinch strength,PS)的关系。方法采用单中心横断面研究,纳入2021年3月暨南大学附属广州红十字会医院血液净化中心行规律MHD的患者,收集受试者的一般资料,透析前测定血常规、血清生化指标和25(OH)D水平(电化学发光免疫法),使用测力计测量HGS和PS水平。根据25(OH)D水平将受试者分为25(OH)D正常组[25(OH)D>30 ng/ml]、25(OH)D不足组[20 ng/ml≤25(OH)D≤30 ng/ml]、25(OH)D缺乏组[25(OH)D<20 ng/ml],比较3组间各指标的差异。应用Spearman相关分析和线性回归评价25(OH)D水平与HGS和PS的相关性。结果共纳入126例MHD患者,25(OH)D正常组28例(22.22%)、不足组42例(33.33%)、缺乏组56例(44.44%)。Spearman相关性分析提示血清25(OH)D水平与HGS(r=0.289,P=0.001)、PS(r=0.289,P=0.001)呈正相关。在调整相关混杂因素后,多元线性回归显示血清25(OH)D水平降低与较低的HGS(β=0.199,95%CI:0.058~0.341,P=0.006)和PS(β=0.052,95%CI:0.017~0.087,P=0.004)独立相关。结论MHD患者血清25(OH)D水平降低是HGS和PS降低的独立相关因素。

Association of handgrip strength with the prevalence of hypertension in a Chinese Han population

Objective: Handgrip strength (HGS) exercise has been reported to reduce blood pressure in both hypertensive and normotensive patients. In this study, we evaluated the association of HGS with hypertension in a Chinese Han Population. Methods: A total of 11,151 subjects mainly consisting of a rural population were recruited with a multi-stage sampling method in Jurong city, Jiangsu Province, China. Besides hypertension and diabetes, major chronic diseases were excluded. HGS was categorized into tertiles by age and gender. Logistic regression was used to estimate the association of HGS and hypertension with the odds ratio (OR) and 95% confidence interval (Cl). Results: From low to high tertiles of HGS, diastolic blood pressure (DBP) was significantly increased (74.52 ± 7.39,74.70 ± 7.03, and 75.54 ± 7.01 mmHg, respectively;Ptrend=0.001), as well as in females (Ptrend=0.003). The differences in DBP among the tertiles of HGS were still significant in females even after adjusting for covariates (Ptrend=0.048). No significant differences in systolic blood pressure (SBP) were observed among the tertiles of HGS (P>0.05). Compared to low HGS, high HGS was significantly associated with hypertension after adjustment for age and gender (adjusted OR,1.19;95% CI, 1.06-1.34;P=0.004). A stratified analysis showed that the significant association of high HGS and hypertension was also observed with the following factors even after adjusting for age and gender: female gender (adjusted OR, 1.25;95% CI, 1.08-1.46;P=0.004), ages of 60-69 years (adjusted OR, 1.29;95% CI, 1.06-1.57;P=O.O11), and married (adjusted OR,1.20;95% CI, 1.06-1.37;P=0.005). However, no significant associations were found after adjusting for age, gender, smoking status, drinking status, body mass index, physical activity level, glucose, high-and low-density lipoprotein cholesterol, total cholesterol, and triglyceride (P>0.05).Conclusion: The findings of the current study suggest that HGS was positively correlated with DBP in a rural population, and high HGS was associated with hypertension in females;however, the association may be modified by smoking status, drinking status, body mass index, physical activity, cholesterol level, and glucose level. Further utilization of HGS exercises to intervene in the development and prognosis of hypertension should be verified in the future.

Association of handgrip strength with semen characteristics:a study with repeated measurements among healthy Chinese men

Accumulating epidemiological evidence shows that handgrip strength provides predictive potential in physical,mental,and reproductive health status.However,the associations between handgrip strength and semen characteristics have not been explored.We recruited 1382 eligible men at the Hubei Province Human Sperm Bank(Wuhan,China)who had their handgrip strength measured at recruitment and provided 6458 repeated semen specimens within a 6-month period.Semen characteristics,including semen volume,sperm motility parameters(immotility,nonprogressive motility,and progressive motility),and sperm concentration,were assessed.Mixed-effect models and restricted cubic spline functions were applied to investigate the relationship of handgrip strength with repeated measurements of semen characteristics.After adjusting for confounding factors,the mixed-effect models revealed that handgrip strength was positively associated with semen volume,sperm concentration,progressive motility,total motility,and total count(all P for trend<0.05).Compared to men in the lowest quartile,those in the highest quartile of handgrip strength had higher semen volume,sperm concentration,progressive motility,total motility,and total count,with measurements of 14.2%(95%confidence interval[CI]:5.9%-23.2%),19.5%(95%CI:7.3%-33.1%),9.5%(95%CI:3.4%-15.9%),8.8%(95%CI:3.2%-14.6%),and 36.4%(95%CI:18.9%-56.5%),respectively.These positive dose-response relationships were further confirmed in restricted cubic splines,where handgrip strength was modeled as a continuous variable.Handgrip strength,as an indicator of muscular function and strength,was positively associated with semen characteristics in a dose-dependentmanner.

Association of low muscle strength with metabolic dysfunctionassociated fatty liver disease:A nationwide study

BACKGROUND There is limited evidence regarding the association between muscle strength and metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the association between muscle strength and MAFLD in the general population in Korea.METHODS This nationwide representative cross-sectional study included 31649 individuals aged≥19 years who participated in the Korea National Health and Nutrition Examination Survey between 2015 and 2018.Odds ratios(ORs)and 95%confidence intervals(95%CIs)for MAFLD according to sex-specific quartiles of muscle strength,defined by relative handgrip strength,were calculated using multivariable logistic regression analysis.Additionally,multivariable logistic regression analysis was used to assess the association between muscle strength and probable liver fibrosis in patients with MAFLD.RESULTS Of all the participants,29.3%had MAFLD.The prevalence of MAFLD was significantly higher in the lower muscle strength quartile groups for all participants,sexes,and age groups(P<0.001).A 1.92-fold(OR=1.92,95%CI:1.70–2.16)and 3.12-fold(OR=3.12,95%CI:2.64–3.69)higher risk of MAFLD was observed in the lowest quartile(Q1)group than in the other groups(Q2–Q4)and the highest quartile(Q4)group,respectively.The ORs of MAFLD were significantly increased in the lower muscle strength quartile groups in a dose-dependent manner(P for trend<0.001).These associations persisted in both sexes.An inverse association between muscle strength and the risk of MAFLD was observed in all subgroups according to age,obesity,and diabetes mellitus.In patients with MAFLD,the odds of severe liver fibrosis were higher in Q1(OR=1.83,95%CI:1.25–2.69)than in other groups(Q2–Q4).CONCLUSION Among Korean adults,low muscle strength was associated with an increased risk of MAFLD and liver fibrosis in patients with MAFLD.

Hemodynamic Fetal Response to Maternal Isometric Exercise in Pregnant Patients with Diabetes

Background: Studies on physical activity during pregnancy and its impact on mother and fetus are still limited. International protocols consider only aerobic exercise and fail to provide information about other modalities such as isometric exercise. Isometric exercise promotes cardiorespiratory resistance and muscle strengthening, but it is rarely tested on pregnant women because it increases maternal blood pressure and can subsequently affect placental circulation. Objectives: To assess the fetal response by use of Doppler study in diabetes pregnant women submitted to isometric exercise. Methods: A cross-sectional experimental study was conducted on 25 diabetes pregnant women with gestational age between 26 and 36 weeks. The patients were submitted to isometric handgrip, and data were collected from the mother (blood pressure, heart rate and Doppler velocimetry for the uterine arteries) and from the fetus (heart rate, Doppler velocimetry for the umbilical artery, middle cerebral artery and ductus venosus). All variables were collected before, during and after the isometric handgrip. Results: There was a significant reduction in the pulsatilityindex (average values pre 0.77 ± 0.30, trans 0.65 ± 0.22, and post 0.75 ± 0.22, with p = 0.001), resistance index (average values pre 0.49 ± 0.12, trans 0.44 ± 0.10, and post 0.48 ± 0.90, with p =

老年住院患者握力和骨骼肌量与营养状况的相关性研究

目的探索老年住院患者握力和骨骼肌量与营养状况的关系。方法对在2020年10月—12月期间于武汉市中心医院全科医学科新入院的142例老年患者进行营养风险筛查(Nutritional Risk Screening 2002,NRS-2002)。测量患者体重、身高、BMI、腰围、小腿围、臀围、上臂围、握力、骨骼肌量和体脂肪。统计患者血液血红蛋白、白蛋白和总蛋白等反映机体营养状况的生化指标。Pearson和Spearman相关分析营养状况与握力及骨骼肌量的相关性。结果老年住院患者NRS-2002评分显示营养不良风险(评分≥3分)构成比为12.6%(18/142),营养不良风险组的握力明显低于无营养不良风险组(评分<3分)[(18.45±10.330)kg/m^(2)vs.(23.49±8.796)kg/m^(2),P=0.028]。营养不良风险组小腿围低于无营养不良风险组[(32.06±3.809)cm vs.(33.91±3.069)cm,P=0.022]。相关性分析显示,握力与NRS-2002评分呈显著负相关,与臀围、小腿围、骨骼肌量、血红蛋白呈正相关,与年龄呈显著负相关。骨骼肌量与NRS-2002评分无明显相关,与握力呈明显的正相关,与腰围、小腿围、臀围、上臂围、血红蛋白、白蛋白呈正相关。结论握力、骨骼肌量可作为老年住院患者的营养筛查指标。