Institute for Sport and Health, University College Dublin, Dublin, Ireland.
Department of Biomedical Sciences, Neuromuscular Physiology Laboratory, CIR-Myo Myology Centre, University of Padova, Padua, Italy.
Aging Clin Exp Res. 2023 Nov;35(11):2563-2571. doi: 10.1007/s40520-023-02539-z. Epub 2023 Sep 2.
Although handgrip strength (HGS) asymmetry has clinical screening utility, its relevance to sarcopenia is unknown. This study examined the relationship between HGS asymmetry and sarcopenia signatures, and explored the relevance of circulating neural/neuromuscular markers.
9403 individuals aged 18-92 years participated in this study. Maximal HGS and skeletal muscle index (SMI) were determined using hand dynamometry and DXA. Sarcopenia was diagnosed upon the presence of low HGS and low SMI, according to cohort-specific thresholds. Plasma biomarkers were measured by ELISA in a sub-group of 269 participants aged 50-83 years. Asymmetry was determined as the highest recorded HGS divided by the highest recorded HGS of the opposite hand. Individuals with a ratio > 1.10 were classified as having asymmetrical HGS.
Subjects with asymmetrical HGS had significantly lower SMI (7.67 kg/m vs 7.71 kg/m, p = 0.004) and lower HGS (37.82 kg vs 38.91 kg, p < 0.001) than those with symmetrical HGS. In those aged ≥ 50 years asymmetrical HGS was associated with 2.67 higher odds for sarcopenia [95% confidence interval: (CI) = 1.557-4.561, p < 0.001], 1.83 higher odds for low HGS only (CI 1.427-2.342, p < 0.001), and 1.79 higher odds for low SMI only (CI 1.257-2.554, p = 0.001). HGS asymmetry demonstrated acceptable diagnostic accuracy for sarcopenia (AUC = 0.727, CI 0.658-0.796, p < 0.001). Plasma neural cell adhesion molecule concentrations were 19.6% higher in individuals with asymmetrical HGS (185.40 ng/mL vs 155.00 ng/mL, p < 0.001) than those with symmetrical HGS.
Our findings demonstrate the utility of HGS asymmetry as a screening tool that may complement existing strategies seeking to combat sarcopenia. Biomarker analyses suggest that heightened denervation may be an important aetiological factor underpinning HGS asymmetry.
握力强度（HGS）不对称具有临床筛查效用，但与肌肉减少症的相关性尚不清楚。本研究旨在探讨 HGS 不对称与肌肉减少症特征之间的关系，并探讨循环神经/神经肌肉标志物的相关性。
本研究纳入了 9403 名年龄在 18-92 岁的参与者。使用手持测力计和 DXA 测定最大握力和骨骼肌指数（SMI）。根据特定队列的阈值，当低握力和低 SMI 同时存在时诊断为肌肉减少症。在 269 名年龄在 50-83 岁的亚组参与者中，通过 ELISA 测量血浆生物标志物。将最高记录的握力除以对侧手的最高记录握力来确定不对称性。比值大于 1.10 的个体被归类为具有不对称握力。
与具有对称握力的个体相比，具有不对称握力的个体的 SMI（7.67kg/m 比 7.71kg/m，p=0.004）和握力（37.82kg 比 38.91kg，p<0.001）明显较低。在年龄≥50 岁的人群中，不对称握力与肌肉减少症的风险增加 2.67 倍（95%置信区间：1.557-4.561，p<0.001），与仅低握力的风险增加 1.83 倍（1.427-2.342，p<0.001），与仅低 SMI 的风险增加 1.79 倍（1.257-2.554，p=0.001）相关。HGS 不对称对肌肉减少症具有可接受的诊断准确性（AUC=0.727，95%置信区间：0.658-0.796，p<0.001）。与具有对称握力的个体相比，具有不对称握力的个体的神经细胞黏附分子浓度高 19.6%（185.40ng/mL 比 155.00ng/mL，p<0.001）。
我们的研究结果表明，HGS 不对称作为一种筛查工具具有实用性，可能补充现有的旨在对抗肌肉减少症的策略。生物标志物分析表明，去神经支配增加可能是 HGS 不对称的一个重要发病因素。
