Mendo Christian W, Ciarciello Andreo, Vary-O'Neal Arielle, Clairoux Natalie, Sylvestre Marie-Pierre, Keezer Mark R
Université de Montréal, Montréal.
Research Centre of the Centre hospitalier de l'Université de Montréal, Montréal.
Can Geriatr J. 2025 Jun 4;28(2):169-179. doi: 10.5770/cgj.28.814. eCollection 2025 Jun.
This scoping review examines how biological sex has been considered in studies investigating the association between grip strength and cardiovascular outcomes and risk factors.
We used the Askey and O'Malley framework, reported as per the PRISMA extension for scoping reviews. A search was conducted in four electronic bibliographic databases to identify relevant peer-reviewed studies published after 2001.
Of the 39 included studies, 82.0% (n = 32) used biological sex as a confounder variable in the association of interest. Two studies used interaction terms between biological sex and grip strength and found no statistically significant interactions. Five studies used sex-stratified analyses alone. Three of these studies found that the cardiovascular risk due to low grip strength is higher in males than in females. Two other studies used both interaction terms between biological sex and grip strength and sex-stratification analyses and found no statistically significant differences. Sociocultural gender was not considered in any of the identified studies.
We found that biological sex was often considered as a confounder variable in the association between grip strength and cardiovascular outcomes, as well as cardiovascular risk factors. On the other hand, two studies reported the presence of effect modification by sex rather than confounding, that these associations were stronger in males versus females. Five other studies did not identify evidence of interaction nor effect modification. Future research is needed to clarify the nature of these associations and understand any potential biological mechanisms.
本范围综述探讨了在研究握力与心血管结局及风险因素之间的关联时，生物性别是如何被考虑的。
我们使用了阿斯凯和奥马利框架，并按照PRISMA扩展版报告范围综述。在四个电子文献数据库中进行了检索，以确定2001年后发表的相关同行评审研究。
在纳入的39项研究中，82.0%（n = 32）将生物性别作为感兴趣关联中的混杂变量。两项研究使用了生物性别与握力之间的交互项，未发现具有统计学意义的交互作用。五项研究仅使用了按性别分层的分析。其中三项研究发现，握力低导致的心血管风险在男性中高于女性。另外两项研究同时使用了生物性别与握力之间的交互项和按性别分层分析，未发现具有统计学意义的差异。在所确定的研究中，均未考虑社会文化性别。
我们发现，生物性别在握力与心血管结局以及心血管风险因素之间的关联中常被视为混杂变量。另一方面，两项研究报告存在性别效应修饰而非混杂，即这些关联在男性中比在女性中更强。其他五项研究未发现交互作用或效应修饰的证据。未来需要开展研究以阐明这些关联的性质，并了解任何潜在的生物学机制。
