Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 215123, Suzhou, P. R. China.
Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, 215009, Suzhou, P. R. China.
BMC Geriatr. 2023 May 4;23(1):268. doi: 10.1186/s12877-023-03953-8.
Stroke and heart disease are two major contributors to the global disease burden. We aimed to evaluate and compare the roles of different handgrip strength (HGS) expressions in predicting stroke and heart disease in three nationally representative cohorts.
This longitudinal study used data from the Health and Retirement Study (HRS), the Survey of Health, Ageing, and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). The Cox proportional hazard model was applied to analyze the relationship between HGS and stroke and heart disease, and Harrell's C index was used to assess the predictive abilities of different HGS expressions.
A total of 4,407 participants suffered from stroke and 9,509 from heart disease during follow-up. Compared with the highest quartile, participants in the lowest quartile of dominant HGS, absolute HGS and relative HGS possessed a significantly higher risk of new-onset stroke in Europe, America, and China (all P < 0.05). After adding HGS to office-based risk factors, there were minimal or no differences in the increases of Harrell's C indexes among three HGS expressions. In contrast, the modest association between HGS and heart disease was only seen in SHARE and HRS, but not in CHARLS.
Our findings support that HGS can be used as an independent predictor of stroke in middle-aged and older European, American and Chinese populations, and the predictive ability of HGS may not depend on how it is expressed. The relationship between HGS and heart disease calls for further validation.
中风和心脏病是全球疾病负担的两个主要因素。我们旨在评估和比较三种具有代表性的队列中不同握力（HGS）表达在预测中风和心脏病方面的作用。
这项纵向研究使用了来自健康与退休研究（HRS）、欧洲健康、老龄化和退休调查（SHARE）和中国健康与退休纵向研究（CHARLS）的数据。应用 Cox 比例风险模型分析 HGS 与中风和心脏病之间的关系，并使用 Harrell's C 指数评估不同 HGS 表达的预测能力。
共有 4407 名参与者在随访期间发生中风，9509 名参与者发生心脏病。与最高四分位组相比，欧洲、美洲和中国的 HGS 优势、绝对 HGS 和相对 HGS 最低四分位组的参与者新发中风的风险明显更高（均 P<0.05）。在将 HGS 添加到基于办公室的风险因素后，三种 HGS 表达之间 Harrell's C 指数的增加差异很小或没有。相比之下，HGS 与心脏病之间的适度关联仅见于 SHARE 和 HRS，而不在 CHARLS 中。
我们的研究结果支持 HGS 可作为中老年人欧洲、美洲和中国人群中风的独立预测指标，HGS 的预测能力可能不取决于其表达方式。HGS 与心脏病之间的关系需要进一步验证。
