Handgrip Strength Is Associated with Metabolic Syndrome and Insulin Resistance in Children and Adolescents: Analysis of Korea National Health and Nutrition Examination Survey 2014-2018

Abstract

Background: Reduced handgrip strength (HGS) is associated with adverse cardiometabolic health outcomes. We examined HGS, metabolic syndrome (MetS), and insulin resistance (IR) in children and adolescents.

Methods: The following population-based data from 2,797 participants (aged 10-18 years) of the Korea National Health and Nutrition Examination Survey 2014-2018 were analyzed: complete anthropometric measures, HGS, MetS, and IR (subgroup with fasting insulin, n=555). HGS was analyzed as the combined HGS (CHGS) and the normalized CHGS (nCHGS=CHGS divided by body weight).

Results: At a mean age of 14.4 years, 276 participants (9.9%) had abdominal obesity, 56 (2.0%) had MetS, and 118 (20.9%) had IR. Individual components of MetS and IR were inversely associated with the nCHGS. The odds ratios (ORs) for MetS and IR decreased significantly with higher nCHGS after adjustment for sex, age, physical activity, and sedentary times. The optimal cut-off values that predicted MetS were 0.80 kg/kg (males) and 0.71 kg/kg (females), with significant associations with MetS (OR: 7.4 in males; 5.7 in females) and IR (OR: 3.3 in males; 3.2 in females) observed when nCHGS values were lower than those cut-offs.

Conclusion: HGS is associated with MetS and IR and might be a useful indicator of cardiometabolic risk factors in children and adolescents.

Keywords: Cardiometabolic risk factors; Handgrip strength; Insulin resistance.

Figure 1

Metabolic syndrome and its components according to sex-specific quartiles of normalized handgrip strength. (A) Metabolic syndrome. (B) Abdominal obesity. (C) Systolic blood pressure (SBP). (D) Fasting glucose. (E) Triglycerides. (F) High-density lipoprotein cholesterol (HDL-C). Odds ratios (ORs) or actual measures of metabolic syndrome and its individual components by quartiles of normalized handgrip strength. The lowest quartile (Q1) to the highest quartile (Q4) are shown for each sex. The analyses were adjusted for age, physical activity, sedentary time, household income, alcohol consumption, and smoking. *P for trend < 0.05.

Figure 2

Measures of glucose homeostasis and insulin resistance according to sex-specific quartiles of normalized handgrip strength. (A) Glycosylated hemoglobin (HbA1c). (B) Fasting insulin. (C) Homeostasis model assessment of insulin resistance (HOMA-IR). Values for the glucose homeostasis and insulin resistance measures by quartiles of normalized handgrip strength from the lowest quartile (Q1) to the highest quartile (Q4) for each sex adjusted by age, physical activity, sedentary time, household income, alcohol consumption, and smoking. *P for trend < 0.05.

Figure 3

Receiver operating characteristic curves for normalized handgrip strength in predicting the presence of metabolic syndrome in males (A) and females (B). AUC, area under the curve.