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Original research
Association between handgrip strength and the risk of new-onset metabolic syndrome: a population-based cohort study
  1. Chao Shen1,
  2. Jiangting Lu1,
  3. Zhijie Xu2,
  4. Yuanyuan Xu2,
  5. Ying Yang1
  1. 1Department of Cardiology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
  2. 2Department of General Practice, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
  1. Correspondence to Dr Ying Yang; yylong{at}


Objectives A lower relative handgrip strength (HGS) may disrupt metabolic homeostasis and then lead to metabolic syndrome (MetS). There is a paucity of longitudinal studies to examine whether relative HGS at baseline is linked to incident MetS. Thus, the purpose of the present study was to explore the association between relative HGS and new-onset MetS.

Design This is an observational and longitudinal research.

A nationally representative sample of population in China.

Participants A total of 3350 subjects without MetS were selected for analysis in the present study. Data are from the China Health and Retirement Longitudinal Study (2011–2015).

Outcome measures We calculated the relative HGS by dividing the HGS by body weight. Participants were divided into gender-specific quartiles. We estimated HRs for MetS and its components using Cox proportional hazard models according to the relative HGS categories.

Results After multiple adjustment, the risk of MetS increased with the lower quartile of relative HGS in both sexes. Using the highest quartile (Q4) as a reference, the HR for quartile Q3–1 was 1.49 (0.95, 2.34), 1.67 (1.08, 2.59) and 1.76 (1.12, 2.78), respectively, in men, and 1.14 (0.82, 1.58), 1.30 (1.02, 1.57) and 1.28 (1.03, 1.55), respectively, in women. Additionally, we observed that relative HGS was negatively or inversely associated with the risk of abdominal obesity in both sexes.

Conclusions The current study demonstrated that relative HGS was inversely and independently associated with an increased risk of MetS and abdominal obesity, suggesting a possible role of relative HGS as a useful and simple index for muscle strength in the prediction of occurrence of MetS.

  • epidemiology
  • internal medicine
  • preventive medicine

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  • Contributors CS, JL and YX designed the study and drafted the manuscript. YY and ZX participated in revising the manuscript. All authors approved the final manuscript.

  • Funding This study was supported by Medical Health Science and Technology program of Zhejiang Province (2018KY492 and 2020KY165).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The data collection was obtained from the Biomedical Ethics Review Committee of Peking University (IRB00001052-11015). The use of China Health and Retirement Longitudinal Study data was obtained from the University of Newcastle’s Human Research Ethics Committee (H-2015-0290).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All of the CHARLS data will be accessible to researchers around the world at the CHARLS project website ( cn/).

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