Association of handgrip strength with self-reported diseases in
					adults in Rio Branco, Acre State, Brazil: a population-based
					study

Amaral, Cledir de Araújo; Portela, Margareth Crisóstomo; Muniz, Pascoal Torres; Farias, Edson dos Santos; Araújo, Thiago Santos de; Souza, Orivaldo Florêncio de

doi:10.1590/0102-311X00062214

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ARTICLE • Cad. Saúde Pública 31 (6) • June 2015 • https://doi.org/10.1590/0102-311X00062214 copy

Association of handgrip strength with self-reported diseases in adults in Rio Branco, Acre State, Brazil: a population-based study

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study aimed to analyze the association of handgrip strength with self-reported diseases and multimorbidity among adults in Rio Branco, Acre State, Brazil, through a population based survey involving 1,395 adults of both sexes. Associations by sex were estimated by logistic regression analysis. The mean handgrip strength in men (44.8kg) is higher than in women (29kg) and decrease with age. The mean handgrip strength difference between those classified as strong and weak was 21kg and 15.5kg for men and woman, respectively. Controlling for age group, body mass index and physical activity when it was relevant, men with low handgrip strength were more likely to have hypertension [OR = 2.21 91.35; 3.61)], diabetes [OR = 4.18 (1.35; 12.95)], musculoskeletal disorders [OR = 1.67 (1.07; 2.61)] and multimorbidity [OR = 1.99 (1.27; 3.12)]. Among woman, associations between handgrip strength and cardiovascular disease, dyslipidemia, musculoskeletal disorders and multimorbidity were not sustained in the multivariate models. This study endorses the use of handgrip strength as a health biomarker.

Handgrip Strength; Morbidity; Health Surveys

Variáveis	Men			Women			Total			χ²***
Variáveis	n	Number expanded *	% **	n	Number expanded *	% **	n	Number expanded *	%	χ²***
Age (years)										0.002
18-39	392	70,844	62.8	432	76,595	56.5	824	147,439	59.3
≥ 40	234	42,020	37.2	337	59,021	43.5	571	101,040	40.7
Leisure-time physical activity										< 0.001
Active	227	40,606	36.0	113	18,974	14.0	340	59,580	24.0
Sedentary	399	72,258	64.0	656	116,641	86.0	1,055	188,899	76.0
BMI										0.001
Underweight	11	1,852	1.6	35	6,195	4.6	46	8,047	3.2
Normal	319	58,561	52.0	341	60,279	44.5	660	118,840	47.9
Overweight	202	35,988	32.0	241	42,818	31.6	443	78,806	31.8
Obese	92	16,159	14.4	151	26,184	19.3	243	42,342	17.1
Self-reported diseases
Hypertension										0.003
No	477	85,197	75.8	522	92,082	67.9	999	177,280	71.5
Yes	147	27,255	24.2	247	43,533	32.1	394	70,788	28.5
Cardiovascular events										0.319
No	594	107,076	95.2	742	130,792	96.4	1,336	237,868	95.9
Yes	30	5,377	4.8	27	4,823	3.6	57	10,200	4.1
Chronic kidney disease										0.780
No	568	102,337	91.0	700	122,818	90.6	1,268	225,155	90.8
Yes	56	10,116	9.0	69	12,798	9.4	125	22,913	9.2
Diabetes mellitus										0.599
No	592	106,865	95.0	735	129,540	95.5	1,327	236,404	95.3
Yes	32	5,588	5.0	34	6,076	4.5	66	11,664	4.7
Dyslipidemia										< 0.001
No	533	96,210	85.6	595	105,429	77.7	1,128	201,639	81.3
Yes	91	16,242	14.4	174	30,187	22.3	265	46,429	18.7
Depression										< 0.001
No	560	100,947	89.8	575	100,505	74.1	1,135	201,453	81.2
Yes	64	11,505	10.2	194	35,110	25.9	258	46,615	18.8
Musculoskeletal disorders										< 0.001
No	411	73,994	65.8	405	71,119	52.4	816	145,113	58.5
Yes	213	38,458	34.2	364	64,497	47.6	577	102,955	41.5
Multimorbidity										< 0.001
No	437	78,665	69.7	424	74,079	54.6	861	152,744	61.5
Yes	189	34,199	30.3	345	61,536	45.4	534	95,735	38.5
Total	626	112,864	45.4	769	135,615	54.6	1,395	248,479	100.0

Age group	Mean	Median	Minimum *	Maximum **	Standard error	Coefficient of variation
Men
18-39 years	46.6	45.8	18	83	0.48	0.010
≥ 40 years	41.6	41.4	12	77	0.81	0.020
Handgrip strength
Strong	55.3	54.0	50	83	0.37	0.006
Moderate	44.9	45.0	41	49	0.17	0.004
Weak	34.2	36.0	12	40	0.43	0.011
Total	44.8	44.4	12	83	0.50	0.011
Mulher
18-39 years	30.5	29.8	11	60	0.34	0.011
≥ 40 years	27.0	26.8	10	46	0.46	0.017
Handgrip strength
Strong	36.0	35.0	32	60	0.25	0.007
Moderate	28.4	28.0	26	31	0.09	0.004
Weak	20.6	21.0	10	25	0.23	0.011
Total	29.0	28.6	10	60	0.35	0.012
Total	36.1	33.9	10	83	0.36	0.010

Reported diseases	OR (95%CI) (model 1) *	OR (95%CI) (model 2) **	OR (95%CI) (model 3) ***
Hypertension
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.89 (1.19; 3.00)	1.77 (1.08; 2.90)	2.05 (1.19; 3.54)
Weak	2.31 (1.47; 3.64)	1.72 (1.09; 2.69)	2.21 (1.35; 3.61)
Age ≥ 40 years	-	4.08 (2.52; 6.60)	3.53 (2.14; 5.83)
BMI	-	-	1.10 (1.04; 1.15)
p-value trend^#	< 0.001	0.021	0.001
% agreement^##	42.3	61.6	73.8
Cardiovascular event
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.52 (0.45; 5.19)	1.35 (0.40; 4.48)	1.42 (0.43; 4.68)
Weak	2.53 (0.76; 8.51)	1.77 (0.57; 5.46)	1.83 (0.60; 5.58)
Age ≥ 40 years	-	4.82 (2.08; 11.18)	4.38 (1.78; 10.78)
BMI	-	-	1.04 (0.96; 1.12)
p-value trend ^#	0.110	0.296	0.263
% agreement ^##	42.1	59.5	67.4
Chronic kidney disease
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.28 (0.64; 2.57)	1.21 (0.60; 2.44)	1.17 (0.57; 2.37)
Weak	0.99 (0.50; 1.93)	0.82 (0.40; 1.69)	0.77 (0.36; 1.64)
Age ≥ 40 years	-	2.10 (1.03; 4.28)	2.21 (1.05; 4.64)
BMI	-	-	0.97 (0.93; 1.02)
p-value trend^#	0.965	0.562	0.468
% agreement^##	36.1	52.6	60.0
Diabetes mellitus
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.62 (0.58; 4.57)	1.42 (0.49; 4.14)	1.67 (0.54; 5.14)
Weak	4.54 (1.50; 13.76)	3.16 (1.06; 9.47)	4.18 (1.35; 12.95)
Age ≥ 40 years	-	5.29 (2.20; 12.75)	4.31 (1.82; 10.23)
BMI	-	-	1.11 (1.05; 1.18)
p-value trend^#	0.008	0.042	0.014
% agreement^##	50.8	69.8	79.5
Dyslipidemia
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.98 (0.55; 1.73)	0.83 (0.46; 1.50)	0.98 (0.52; 1.88)
Weak	1.36 (0.78; 2.39)	0.88 (0.48; 1.62)	1.31 (0.71; 2.40)
Age ≥ 40 years	-	6.00 (3.86; 9.33)	5.16 (3.33; 7.99)
BMI	-	-	1.16 (1.10; 1.22)
p value trend^#	0.277	0.716	0.382
% agreement^##	36.5	64.3	80.2
Depression
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.86 (0.93; 3.74)	1.78 (0.88; 3.57)	1.78 (0.88; 3.58)
Weak	0.87 (0.43; 1.76)	0.73 (0.35; 1.52)	0.73 (0.36; 1.50)
Age ≥ 40 years	-	2.01 (1.14; 3.55)	2.01 (1.12; 3.63)
BMI	-	-	1.00 (0.93; 1.07)
p-value trend^#	0.673	0.340	0.339
% agreement^##	41.6	55.5	55.6
Musculoskeletal disorders
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.48 (0.96; 2.28)	1.38 (0.86; 2.19)	1.34 (0.85; 2.09)
Weak	2.28 (1.45; 3.59)	1.76 (1.13; 2.74)	1.67 (1.07; 2.61)
Age ≥ 40 years	-	3.61 (2.54; 5.14)	3.73 (2.54; 5.47)
BMI	-	-	0.98 (0.94; 1.02)
p-value trend^#	< 0.001	0.013	0.027
% agreement^##	42.2	60.9	68.3
Multimorbidity
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.42 (0.93; 2.18)	1.30 (0.83; 2.02)	1.41 (0.90; 2.22)
Weak	2.34 (1.51; 3.63)	1.72 (1.09; 2.73)	1.99 (1.27; 3.12)
Age ≥ 40 years	-	4.72 (3.35; 6.64)	3.80 (2.67; 5.41)
BMI	-	-	1.06 (1.01; 1.11)
Leisure-time physical activity	-	-	1.72 (1.09; 2.71)
p-value trend ^#	< 0.001	0.022	0.003
% agreement ^##	42.5	64.1	74.0

Reported diseases	OR (95%CI) (model 1) *	OR (95%CI) (model 2) **	OR (95%CI) (model 3) ***
Hypertension
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.81 (0.58; 1.13)	0.74 (0.51; 1.05)	0.90 (0.60; 1.36)
Weak	1.17 (0.79; 1.74)	0.81 (0.53; 1.22)	1.03 (0.64; 1.64)
Age ≥ 40 years	-	3.25 (2.47; 4.28)	2.22 (1.61; 3.05)
BMI	-	-	1.44 (1.05; 1.96)
p-value trend ^#	0.495	0.287	0.947
% agreement ^##	38.1	57.7	73.4
Cardiovascular event
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.89 (0.32; 2.44)	0.81 (0.30; 2.14)	0.81 (0.29; 2.25)
Weak	2.46 (1.11; 5.47)	1.66 (0.72; 3.81)	1.65 (0.70; 3.89)
Age ≥ 40 years	-	4.09 (1.47; 11.36)	4.14 (1.59; 10.81)
BMI	-	-	1.00 (0.94; 1.06)
p-value trend ^#	0.037	0.233	0.246
% agreement ^##	45.0	63.1	64.9
Chronic kidney disease
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.65 (0.34; 1.25)	0.63 (0.33; 1.22)	0.65 (0.34; 1.24)
Weak	0.69 (0.34; 1.39)	0.62 (0.31; 1.23)	0.64 (0.32; 1.26)
Age ≥ 40 years	-	1.41 (0.71;2.79)	1.36 (0.69; 2.66)
BMI	-	-	1.01 (0.97; 1.06)
p-value trend ^#	0.291	0.169	0.191
% agreement ^##	37.4	47.0	54.5
Diabetes mellitus
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.90 (0.32; 2.49)	0.80 (0.29; 2.20)	0.78 (0.29; 2.09)
Weak	1.34 (0.49; 3.70)	0.81 (0.31; 2.14)	0.87 (0.35; 2.19)
Age ≥ 40 years	-	6.70 (2.88; 15.58)	5.85 (2.33;1 4.66)
BMI	-	-	1.03 (0.96; 1.10)
p-value trend ^#	0.591	0.683	0.790
% agreement ^##	37.6	63.7	71.9
Dyslipidemia
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.79 (0.51;1.22)	0.70 (0.46;1.05)	0.79 (0.52;1.18)
Weak	1.63 (1.03;2.57)	1.05 (0.66;1.66)	1.25 (0.79;1.97)
Age ≥ 40 years	-	4.48 (3.16;6.35)	3.56 (2.37;5.39)
BMI	-	-	1.08 (1.03;1.12)
p value trend ^#	0.055	0.862	0.369
% agreement ^##	42.0	62.7	74.1
Depression
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	1.04 (0.72;1.50)	1.01 (0.70;1.46)	1.06 (0.73;1.54)
Weak	1.38 (0.93;2.04)	1.16 (0.77;1.75)	1.23 (0.82;1.87)
Age ≥ 40 years	-	1.73 (1.35;2.21)	1.59 (1.19;2.13)
BMI	-	-	1.03 (0.99;1.06)
p-value trend ^#	0.122	0.487	0.327
% agreement ^##	36.6	44.5	59.1
Musculoskeletal disorders
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.92 (0.67;1.27)	0.84 (0.61;1.14)	0.83 (0.60;1.14)
Weak	1.73 (1.23;2.44)	1.17 (0.78;1.76)	1.16 (0.76;1.78)
Age ≥ 40 years	-	3.84 (2.85;5.17)	3.85 (2.80;5.30)
BMI	-	-	1.00 (0.97;1.03)
p-value trend ^#	0.002	0.528	0.553
% agreement ^##	40.2	60.5	66.8
Multimorbidity
Handgrip strength
Strong	1.00	1.00	1.00
Moderate	0.89 (0.64;1.23)	0.78 (0.55;1.11)	0.87 (0.61;1.23)
Weak	1.70 (1.18;2.45)	1.06 (0.71;1.59)	1.24 (0.83;1.85)
Age ≥ 40 years	-	4.93 (3.73;6.50)	4.10 (3.07;5.48)
BMI	-	-	1.07 (1.03;1.10)
p-value trend ^#	0.006	0.859	0.337
% agreement ^##	40.5	62.9	73.8

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[1] Correspondence. C. A. Amaral. Instituto Federal do Acre. Av. Brasil 920, Rio Branco, AC 69903-068, Brasil. cledir.amaral@ifac.edu.br