Paediatric dominant and non-dominant handgrip reference curves and the association with body composition

Abstract

Background

Lack of paediatric reference data limits the utility of handgrip strength as a measure of fitness and well-being.

Aim

To develop paediatric handgrip reference curves and evaluate associations with body size and composition and race/ethnicity group.

Subjects and methods

Handgrip, body size and composition data were obtained from National Health and Nutrition Examination Survey 2011–2014 participants aged 6–20 years. Densitometry-derived fat and appendicular lean soft tissue mass index Z-scores (FMIZ, ALSTMIZ) were generated in participants >8 years. Dominant and non-dominant handgrip reference curves were created using the LMS method. Analyses included sample weights to produce nationally representative estimates.

Results

Differences in handgrip strength according to hand dominance increased with age. Handgrip strength was associated with height and arm length Z-scores (R = 0.42 to 0.47) and ALSTMIZ (R = 0.54). Handgrip strength was higher in the non-Hispanic Black group and lower in the Mexican American compared to non-Hispanic White group. Group differences were attenuated when adjusted for height, arm length or ALSTMIZ.

Conclusion

Paediatric handgrip reference curves were generated from which individual Z-scores can be calculated separately for dominant versus non-dominant hand and adjusted for body size. Association with ALSTMIZ suggests handgrip Z-score may be used as a measure of functional body composition.

Keywords:

• Muscle
• densitometry
• children
• NHANES

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are openly available from the Centres for Disease Control and Prevention (CDC), National Centre for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, 2011–2014, https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/overview.aspx?BeginYear=2011 and https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/overview.aspx?BeginYear=2013.

Additional information

Funding

There were no outside funding sources for this work. Dr. Avitabile is supported by 1K23 HL150337-01. Dr. Weber is supported by R01 DK112955-06. This research was supported by the Nutrition Centre and the Research Institute of the Children’s Hospital of Philadelphia.