National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.
Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK.
Diabetes Metab Res Rev. 2021 Feb;37(2):e3365. doi: 10.1002/dmrr.3365. Epub 2020 Jul 18.
Evolving debate suggests that handgrip strength (HGS), a measure of muscular strength, might be associated with the risk of type 2 diabetes (T2D); however, the evidence is conflicting. Using a systematic review and meta-analysis of published observational cohort studies in general populations, we aimed to assess the association of HGS with the future risk of T2D.
Relevant studies were sought from inception until April 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Transformed or extracted relative risks (RRs) with 95% confidence intervals (CIs) comparing the top vs bottom thirds of HGS levels were pooled using random effects meta-analysis.
A total of 10 unique observational cohort studies comprising of 177 826 participants and >5167 T2D cases were eligible. The pooled multivariable RR (95% CI) for T2D comparing the top vs bottom thirds of HGS levels was 0.73 (0.63-0.84). This association was consistent across several relevant subgroups except for evidence of effect modification by sample size (P value for meta-regression <.001): evidence of an association in smaller studies (<250 events) 0.50 (0.40-0.63), with no significant association in bigger studies (≥250 events) 0.87 (0.73-1.05). There was no evidence of small study effects using formal tests such as funnel plots and Egger's regression symmetry test.
Pooled analysis of observational cohort studies suggests that HGS may be a risk indicator for T2D in the general population. The role of utilizing HGS measurements in T2D prevention strategies warrants further investigation.
不断发展的争论表明，握力（HGS）作为肌肉力量的一种衡量标准，可能与 2 型糖尿病（T2D）的风险有关；然而，证据相互矛盾。本研究通过对一般人群中已发表的观察性队列研究进行系统评价和荟萃分析，旨在评估 HGS 与未来 T2D 风险的相关性。
从 MEDLINE、Embase、Web of Science 以及相关文章的手工检索中，检索截至 2020 年 4 月的所有相关研究。使用随机效应荟萃分析，汇总了比较 HGS 水平最高与最低三分位数的相对风险（RR）及其 95%置信区间（CI）。
共纳入 10 项独特的观察性队列研究，包括 177826 名参与者和>5167 例 T2D 病例。汇总比较 HGS 水平最高与最低三分位数的多变量 RR（95%CI）为 0.73（0.63-0.84）。这种关联在几个相关亚组中是一致的，但样本量的效应修饰存在证据（荟萃回归 P 值<.001）：在较小的研究（<250 例事件）中存在关联（0.50 [0.40-0.63]），在较大的研究（≥250 例事件）中无显著关联（0.87 [0.73-1.05]）。使用漏斗图和 Egger 回归对称性检验等正式检验方法，没有发现小样本研究的效应。
对观察性队列研究的汇总分析表明，HGS 可能是一般人群中 T2D 的风险指标。利用 HGS 测量值在 T2D 预防策略中的作用值得进一步研究。
