Chen Xue, Lin Yi, Dong Weisong, Wen Xiuxiu, Zuo Yidan
Department of Endocrinology, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou, China.
Department of Reproductive Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
BMC Endocr Disord. 2025 Feb 12;25(1):35. doi: 10.1186/s12902-025-01862-y.
To examine the relationship between grip strength (GS) and diabetic nephropathy (DN).
Data on patients with type 2 diabetes mellitus collected between 2011 and 2014 were obtained from National Health and Nutrition Examination Survey (NHANES). Demographic characteristics (sex, age, race, marital status, and educational level), clinical measures (smoking status, drinking status, body mass index [BMI], glycated hemoglobin [HbA1c], urinary albumin creatinine ratio [UACR], diabetes duration, and hypertension), and grip strength assessments were collected. The relationship between GS and DN was analyzed using a logistic regression model. Subgroup analyses were showed as forest plots, conducted while accounting for confounding variables. Restricted cubic splines were applied to investigate nonlinear correlations. A sensitivity analysis was conducted to assess the robustness of the findings.
This study included 1,539 participants. In the multivariate logistic regression model, the odds ratios (ORs) were 0.96 (95% CI, 0.94-0.98) in male and 0.94 (95% CI, 0.91-0.98) in female. Compared with those in the lowest quartiles, participants in the uppermost GS quartiles were less susceptible to DN in male [OR 0.35 (95% CI, 0.20-0.62)] and female [OR 0.37 (95% CI, 0.20-0.67)] (p for trend < 0.001). After adjusting for all variables, the ORs were 0.96 (95% CI, 0.94-0.98) in male and 0.94 (95% CI, 0.91-0.98) in female. Compared with those in the lowest quartiles, participants in the uppermost GS quartiles were less susceptible to DN in male [OR 0.35 (95% CI, 0.20-0.62)] (p for trend < 0.001) and female [OR 0.37 (95% CI, 0.20-0.67)] (p for trend < 0.001). Subgroup analysis demonstrated a reliable connection between GS and DN (all p for interaction > 0.05). We discovered a nonlinear relationship between GS and DN in both male and female participants (all p for nonlinearity < 0.05). More precisely, the data revealed L-shaped relationship and inverted-S relation in male and female participants, respectively.
The results of this cross-sectional study using NHANES data indicated a potential negative association between GS and DN. Additional extensive studies are necessary to elucidate these trends.
探讨握力（GS）与糖尿病肾病（DN）之间的关系。
从国家健康与营养检查调查（NHANES）中获取2011年至2014年收集的2型糖尿病患者的数据。收集人口统计学特征（性别、年龄、种族、婚姻状况和教育水平）、临床指标（吸烟状况、饮酒状况、体重指数[BMI]、糖化血红蛋白[HbA1c]、尿白蛋白肌酐比值[UACR]、糖尿病病程和高血压）以及握力评估数据。使用逻辑回归模型分析GS与DN之间的关系。亚组分析以森林图形式呈现，在考虑混杂变量的情况下进行。应用受限立方样条来研究非线性相关性。进行敏感性分析以评估研究结果的稳健性。
本研究纳入了1539名参与者。在多变量逻辑回归模型中，男性的比值比（OR）为0.96（95%置信区间，0.94 - 0.98），女性为0.94（95%置信区间，0.91 - 0.98）。与最低四分位数组的参与者相比，握力最高四分位数组的男性[OR 0.35（95%置信区间，0.20 - 0.62）]和女性[OR 0.37（95%置信区间，0.20 - 0.67）]患DN的可能性较小（趋势p < 0.001）。在对所有变量进行调整后，男性的OR为0.96（95%置信区间，0.94 - 0.98），女性为0.94（95%置信区间，0.91 - 0.98）。与最低四分位数组的参与者相比，握力最高四分位数组的男性[OR 0.35（95%置信区间，0.20 - 0.62）]（趋势p < 0.001）和女性[OR 0.37（95%置信区间，0.20 - 0.67）]（趋势p < 0.001）患DN的可能性较小。亚组分析表明GS与DN之间存在可靠的关联（所有交互作用p > 0.05）。我们发现男性和女性参与者中GS与DN之间均存在非线性关系（所有非线性p < 0.05）。更确切地说，数据分别显示男性参与者呈L形关系，女性参与者呈倒S形关系。
这项使用NHANES数据的横断面研究结果表明GS与DN之间可能存在负相关。需要进一步进行广泛研究以阐明这些趋势。
