Association between handgrip strength and metabolic syndrome in relation to gender and adiposity among middle aged and older Saudi populations

Figures & data

Figure 1. Flow chart of participants’ enrollment in the study.

Table 1. Comparison of clinical characteristics and adiposity indices based on HGS cut-off for values of probable sarcopenia in men and women.

Parameters	All			Men			Women
	<27 M and 16F	>27 M and 16F	p Value	<27 HGS	>27 HGS	p Value	< 16 HGS	> 16 HGS	p Value
N	87	468		31	256		56	212
Age (year)	60.4 ± 9.3	55.1 ± 9.3	<0.001	56.8 ± 10.9	50.6 ± 9.1	0.001	62.4 ± 7.6	60.4 ± 6.3	0.051
Height (cm)	158.3 ± 9.5	162.5 ± 9.6	<0.001	167.7 ± 6.5	169.6 ± 6.1	0.12	153.1 ± 6.5	153.9 ± 4.8	0.30
Weight (kg)	78.9 ± 13.3	83.8 ± 16.0	0.008	84.9 ± 14.9	88.0 ± 17.1	0.34	75.6 ± 11.0	78.7 ± 13.0	0.10
BMI (kg/m^2)	31.6 ± 5.0	31.9 ± 5.7	0.66	30.3 ± 5.0	30.8 ± 5.8	0.66	32.3 ± 4.9	33.2 ± 5.4	0.25
WC (cm)	104.3 ± 12.5	10.4.0 ± 12.6	0.85	107.5 ± 13.2	104.7 ± 13.5	0.26	102.5 ± 11.9	103.2 ± 11.4	0.69
SBP (mm/Hg)	130.7 ± 20.4	127.9 ± 17.1	0.19	143.6 ± 22.7	131.6 ± 17.7	0.001	123.6 ± 15.1	123.7 ± 15.1	0.95
DBP (mm/Hg)	79.4 ± 9.5	79.8 ± 10.1	0.70	84.2 ± 11.9	82.6 ± 10.4	0.43	76.7 ± 6.6	76.5 ± 8.7	0.85
Fat mass (kg)	28.8 ± 8.8	29.6 ± 9.9	0.47	24.6 ± 9.7	26.9 ± 10.1	0.23	31.1 ± 7.4	32.8 ± 8.6	0.17
Fat percentage (%)	36.2 ± 8.3	34.7 ± 8.1	0.13	28.2 ± 7.3	29.5 ± 6.3	0.26	40.6 ± 4.6	41.1 ± 4.8	0.56
Triglycerides (mg/dL)	150.3 ± 66.2	159.4 ± 80.1	0.32	167.5 ± 72.3	170.1 ± 80.7	0.86	140.9 ± 61.2	146.6 ± 77.7	0.61
HDL (mg/dL)	52.7 ± 13.7	52.6 ± 12.5	0.95	44.2 ± 11.3	48.4 ± 11.1	0.046	57.7 ± 12.5	57.8 ± 12.3	0.96
HGS (kg)	17.3 ± 5.2	28.9 ± 8.9	<0.001	23.6 ± 2.8	35.9 ± 5.7	<0.001	13.8 ± 1.8	20.6 ± 2.9	<0.001
HGS/BMI	0.57 ± 0.21	0.94 ± 0.35	<0.001	0.80 ± 0.16	1.20 ± 0.30	<0.001	0.44 ± 0.09	0.64 ± 0.13	<0.001
HGS/weight	0.22 ± 0.07	0.35 ± 0.10	<0.001	0.29 ± 0.06	0.42 ± 0.09	<0.001	0.19 ± 0.04	0.27 ± 0.05	<0.001
HGS/%fat	0.55 ± 0.40	0.93 ± 0.50	<0.001	0.93 ± 0.41	1.28 ± 0.43	<0.001	0.35 ± 0.07	0.51 ± 0.09	<0.001
MetS
No	42 (48.3)	231 (49.4)	0.47	11 (35.5)	137 (53.5)	0.044	31 (55.4)	94 (44.3)	0.09
Yes	45 (51.7)	237 (50.6)		20 (64.5)	119 (46.5)		25 (44.6)	118 (55.7)

Data are presented as mean ± standard deviation; p Values are significant at the 0.05 and 0.01 levels. N: number; BMI: body mass index; WC: waist circumference; SBP: systolic blood pressure; DBP: diastolic blood pressure; HDL: high-density lipoprotein; HGS: hand grip strength

Table 2. Comparison of clinical characteristics, adiposity indices, and HGS in control and patients with MetS.

Parameters	All			Men			Women
	Control	MetS	p Value	Control	MetS	p Value	Control	MetS	p Value
n	273	282		148	139		125	143
Age (year)	53.9 ± 9.5	57.8 ± 9.1	<0.001	48.6 ± 8.5	54.1 ± 9.7	<0.001	60.3 ± 6.3	61.3 ± 6.9	0.19
Height (cm)	162.5 ± 9.5	161.2 ± 9.8	0.12	169.3 ± 6.4	169.4 ± 6.0	0.94	154.4 ± 5.2	153.2 ± 5.2	0.07
Weight (kg)	81.8 ± 16.8	84.2 ± 14.6	0.08	85.9 ± 18.8	89.6 ± 14.3	0.06	77.1 ± 12.5	78.9 ± 12.8	0.23
BMI (kg/m^2)	31.0 ± 5.7	32.7 ± 5.5	0.001	29.9 ± 5.8	31.6 ± 5.5	0.009	32.4 ± 5.2	33.6 ± 5.3	0.047
WC (cm)	101.1 ± 13.1	32.7 ± 5.5	<0.001	101.2 ± 14.1	109.1 ± 11.4	<0.001	100.9 ± 11.7	104.9 ± 10.9	0.003
SBP (mm/Hg)	122.4 ± 16.1	134.3 ± 17.2	<0.001	125.5 ± 16.9	140.8 ± 17.3	<0.001	118.8 ± 14.2	127.9 ± 14.5	<0.001
DBP (mm/Hg)	77.1 ± 8.9	82.3 ± 10.3	<0.001	79.3 ± 9.7	86.5 ± 10.2	<0.001	74.5 ± 7.3	78.3 ± 8.7	<0.001
Fat mass (kg)	28.4 ± 10.3	30.5 ± 9.0	0.012	25.4 ± 10.9	27.9 ± 8.9	0.029	31.9 ± 8.2	32.9 ± 8.5	0.36
Fat Percentage (%)	33.9 ± 8.7	35.9 ± 7.4	0.005	28.2 ± 6.8	30.7 ± 5.7	0.001	40.9 ± 4.5	41.0 ± 4.9	0.83
Triglycerides (mg/dL)	126.5 ± 58.6	188.5 ± 82.5	<0.001	140.9 ± 69.9	200.6 ± 78.3	<0.001	109.5 ± 34.9	176.8 ± 84.9	<0.001
HDL (mg/dL)	55.5 ± 12.8	49.9 ± 12.0	<0.001	49.9 ± 10.9	45.8 ± 11.2	0.002	62.2 ± 11.8	53.9 ± 11.5	<0.001
HGS (kg)	27.6 ± 9.8	26.8 ± 9.2	0.32	35.1 ± 6.5	34.1 ± 6.9	0.22	18.7 ± 3.7	19.6 ± 4.0	0.044
HGS/BMI	0.93 ± 0.38	0.85 ± 0.33	0.009	1.21 ± 0.30	1.10 ± 0.30	0.001	0.59 ± 0.14	0.60 ± 0.15	0.66
HGS/Weight	0.34 ± 0.12	0.32 ± 0.10	0.010	0.42 ± 0.10	0.39 ± 0.08	0.001	0.25 ± 0.06	0.25 ± 0.10	0.40
HGS/%Fat	0.94 ± 0.60	0.81 ± 0.40	0.003	1.34 ± 0.50	1.15 ± 0.30	<0.001	0.46 ± 0.10	0.49 ± 0.12	0.08

Data are presented as mean ± standard deviation for continuous normal variables; p values are significant at the 0.05 and 0.01 levels.

N: number; BMI: body mass index; WC: waist circumference; SBP: systolic blood pressure; DBP: diastolic blood pressure; HDL: high-density lipoprotein; HGS: hand grip strength

Table 3. ROC analysis for all participants and separately for both genders using MetS and its components as dicotomus in relation to HGS and different adiposity indices ratios.

Parameters	MetS	WC > 94M and 80F	Hypertension 130/85	TG > 150	HDL < 40M and 50F
All
HGS (kg)	0.52 (0.47–0.57)	0.72 (0.66–0.77)**	0.42 (0.37–0.47)**	0.59 (0.55–0.64)**	0.60 (0.55–0.66)**
HGS/BMI	0.56 (0.51–0.60)*	0.88 (0.84–0.92)**	0.43 (0.38–0.48)**	0.58 (0.53–0.63)**	0.61 (0.55–0.67)**
HGS/weight	0.55 (0.50–0.60)*	0.90 (0.87–0.94)**	0.44 (0.39–0.48)*	0.57 (0.52–0.62)**	0.60 (0.54–0.66)**
HGS/fat (%)	0.55 (0.49–0.59)	0.88 (0.83–0.92)**	0.43 (0.38–0.48)**	0.59 (0.54–0.64)**	0.59 (0.53–0.65)**
Men
HGS (kg)	0.54 (0.47–0.60)	0.47 (0.39–0.56)	0.54 (0.47–0.61)	0.52 (0.45–0.58)	0.55 (0.45–0.64)
HGS/BMI	0.60 (0.53–0.67)**	0.79 (0.73–0.86)**	0.56 (0.48–0.63)	0.50 (0.44–0.57)	0.54 (0.44–0.64)
HGS/weight	0.61 (0.54–0.67)**	0.84 (0.78–0.89)**	0.57 (0.50–0.64)*	0.51 (0.44–0.58)	0.56 (0.45–0.66)
HGS/fat (%)	0.61 (0.55–0.68)**	0.79 (0.72–0.86)**	0.61 (0.53–0.67)**	0.51 (0.44–0.58)	0.49 (0.39–0.60)
Women
HGS (kg)	0.44 (0.37–0.51)	0.51 (0.34–0.68)	0.53 (0.45–0.60)	0.49 (0.42–0.56)	0.47 (0.40–0.55)
HGS/BMI	0.49 (0.42–0.56)	0.82 (0.65–0.98)	0.53 (0.45–0.60)	0.44 (0.36–0.51)	0.50 (0.43–0.58)
HGS/weight	0.48 (0.41–0.55)	0.90 (0.79–1.0)*	0.51 (0.44–0.58)	0.44 (0.37–0.51)	0.50 (0.43–0.58)
HGS/fat (%)	0.45 (0.38–0.52)	0.77 (0.57–0.96)	0.51 (0.43–0.58)	0.46 (0.39–0.53)	0.48 (0.40–0.56)

Data are presented as receiver operating characteristic values (95% confidence intervals).

* and ** represents significant p values at the 0.05 and 0.01 levels.

HGS: handgrip strength; BMI: body mass index; % fat: fat percentage; MetS: metabolic syndrome; TG: triglycerides; HDL: high-density lipoprotein

Table 4. Odd ratios of HGS (adjusted to age and gender) based on the quartiles for MetS.

Parameters	HGS		HGS/Weight		HGS/BMI		HGS/%Fat
	Odd ratio (95%CI)	p Value	Odd ratio (95%CI)	p Value	Odd ratio (95%CI)	p Value	Odd ratio (95%CI)	p Value
Overall
Q1	1		1		1		1
Q2	1.12 (0.68–1.82)	0.664	1.47 (0.892.44)	0.133	1.12 (0.68–1.84)	0.652	1.12 (0.68–1.84)	0.646
Q3	1.13 (0.68–1.86)	0.628	0.85 (0.51–1.39)	0.513	0.74 (0.45–1.23)	0.247	0.82 (0.50–1.35)	0.443
Q4	1.59 (0.95–2.64)	0.074	0.91 (0.56–1.46)	0.700	0.95 (0.57–1.56)	0.826	0.91 (0.55–1.51)	0.713
Men
Q1	1		1		1		1
Q2	0.86 (0.43–1.72)	0.677	1.38 (0.65–2.92)	0.399	0.85 (0.42–1.73)	0.653	1.01 (0.4–2.04)	0.998
Q3	1.06 (0.52–2.18)	0.870	0.68(0.35–1.35)	0.271	0.81(0.39–1.66)	0.567	0.59(0.29–1.21)	0.151
Q4	1.23 (0.59–2.54)	0.571	0.54 (0.27–1.06)	0.073	0.49 (0.24–1.04)	0.064	0.46 (0.22–0.95)	0.035
Women
Q1	1		1		1		1
Q2	1.47 (0.74–2.92)	0.273	1.66 (0.83–3.31)	0.148	1.51 (0.74–3.05)	0.250	1.33 (0.66–2.67)	0.421
Q3	1.24 (0.61–2.50)	0.554	1.05 (0.49–2.23)	0.894	0.66 (0.33–1.33)	0.242	1.17 (0.57–2.36)	0.669
Q4	2.09 (1.02–4.28)	0.044	1.47 (0.75–2.88)	0.263	1.69 (0.85–3.42)	0.137	1.86 (0.91–3.84)	0.092

Data are presented as odds ratios (95% confidence intervals). p Value significant at 0.05 and 0.01 level.

HGS: hand grip strength; MetS; metabolic syndrome; BMI; body mass index; % fat; fat percentage The overall model was adjusted for sex and age, and models for men and women were adjusted for age.

Table 5. Linear regression analysis for metabolic syndrome components with age, handgrip strength, and body composition.

Parameters	WC	SBP	DBP	HDL	Triglycerides
Model 1
Men
Adjusted R^2	0.807	0.173	0.002	−0.002	0.0001
Age	0.26 (0.18–0.33)**	0.82 (0.60–1.04)**	0.09 (−0.04 to 0.23)	0.002 (−0.14 to 0.15)	−0.84 (−1.87 to 0.18)
Weight	0.72 (0.68–0.77)**	0.15 (0.03–0.27)*	0.05 (−0.03 to 0.13)	−0.06 (−0.14 to 0.03)	0.17 (−0.40 to 0.75)
HGS	−0.23 (−0.34 to −0.12)**	−0.07 (−0.39 to 0.25)	0.003(−0.19 to 0.20)	0.12 (−0.09 to 0.34)	−0.31 (−1.82 to 1.21)
Women
Adjusted R^2	0.556	0.043	−0.004	0.026	0.001
Age	0.36 (0.22–0.50)**	0.49 (0.21–0.75)**	0.04 (−0.11 to 0.20)	0.02 (−0.21 to 0.24)	0.21 (−1.16 to 1.57)
Weight	0.67 (0.59–0.74)**	0.06 (−0.08 to 0.20)	−0.04 (−0.12 to 0.04)	−0.18 (−0.30 to −0.06)**	0.65 (−0.07 to -1.36)
HGS	−0.30 (−0.54 to −0.06)*	−0.21 (−0.67 to 0.26)	−0.09 (−0.35 to 0.17)	−0.07 (−0.46 to 0.32)	0.09 (−2.27 to 2.45)
Model 2
Men
Adjusted R^2	0.791	0.169	0.016	−0.005	0.004
Age	0.23 (0.15–0.31)**	0.82 (0.60–1.04)**	0.10 (−0.03 to 0.23)	0.008 (−0.14 to 0.15)	−0.82 (−1.84 to 0.21)
BMI	2.10 (1.97–2.23)**	0.43 (0.07–0.78)*	0.26 (0.04–0.47)	−0.10 (−0.33 to 0.13)	0.99 (−0.67 to 2.65)
HGS	−0.07 (−0.18 to 0.05)	0.01 (−0.30 to -0.33)	0.04 (−0.14 to 0.23)	0.11 (−0.09 to 0.32)	−0.18 (−1.66 to 1.29)
Women
Adjusted R^2	0.590	0.045	−0.005	0.021	−0.002
Age	0.26 (0.12–0.39)**	0.47 (0.20–0.75)**	0.05 (−0.11 to 0.20)	0.04 (−0.18 to 0.27)	0.13 (−1.24 to 1.50)
BMI	1.64 (1.46–1.81)**	0.20 (−0.14 to 0.53)	−0.06 (−0.25 to 0.13)	−0.40 (-0.68 to −0.12)**	1.31 (−0.40 to 3.10)
HGS	−0.19 (−0.42 to 0.05)	−0.20 (−0.67 to 0.26)	−0.10 (−0.36 to 0.16)	−0.11 (−0.49 to 0.28)	0.25 (−2.10 to 2.59)
Model 3
Men
Adjusted R^2	0.628	0.161	0.014	−0.006	0.008
Age	0.05 (−0.05 to 0.16)	0.79 (0.56–1.01)**	0.08 (−0.06 to 0.22)	0.02 (−0.13 to 0.16)	−0.93 (−1.95 to 0.10)
Fat (%)	1.66 (1.51–1.82)**	0.27 (−0.05 to 0.59)	0.22 (0.02–0.41)*	−0.08 (−0.28 to 0.13)	1.15 (−0.33 to 2.63)
HGS	−0.006 (−0.16 to 0.15)	0.04 (−0.28 to 0.35)	0.04 (−0.15 to 0.24)	0.11 (−0.10 to 0.32)	−0.22 (−1.68 to 1.25)
Women
Adjusted R^2	0.449	0.041	−0.006	0.011	−0.009
Age	0.24 (0.08–0.39)**	0.49 (0.22–0.76)**	0.05 (−0.11 to 0.20)	0.05 (−0.18 to 0.28)	0.15 (−1.22 to 1.52)
Fat (%)	1.57 (1.36–1.79)**	−0.09 (−0.47 to 0.28)	−0.05 (−0.27 to 0.16)	−0.35 (−0.67 to −0.04)*	0.68 (−1.23 to 2.59)
HGS	−0.08 (−0.35 to 0.19)	−0.16 (−0.63 to 0.30)	−0.11 (−0.37 to 0.15)	−0.14 (−0.52 to 0.25)	0.38 (−1.96 to 2.73)

Data are presented as beta (95% confidence interval) and adjusted R2 explains the variation in the model.

* and ** represent significant p values at the 0.05 and 0.01 levels.

HGS: handgrip strength; BMI: body mass index; % fat: fat percentage; MetS; metabolic syndrome; TG: triglycerides; HDL: high-density lipoprotein

Table 6. Logistic regression analysis for MetS.

Parameters			Men		Women
	β ± S.E	Odd ratio (95%CI)	p Value	B ± S.E	Odd ratio (95%CI)	p Value
	Model 1
Age	0.07 ± 0.02	1.07 (1.04–1.10)	<0.001	0.03 ± 0.02	1.03 (0.99–1.07)	0.090
Weight	0.02 ± 0.008	1.03 (1.01–1.05)	0.006	0.01 ± 0.01	1.01 (0.98–1.03)	0.357
HGS	−0.02 ± 0.02	0.98 (0.94–1.02)	0.461	0.07 ± 0.03	1.07 (1.0–1.15)	0.037
	Model 2
Age	0.07 ± 0.02	1.07 (1.04–1.11)	<0.001	0.03 ± 0.02	1.03 (0.99–1.07)	0.115
BMI	0.08 ± 0.02	1.08 (1.03–1.13)	0.001	0.04 ± 0.03	1.04 (0.99–1.09)	0.089
HGS	−0.01 ± 0.02	0.99 (0.95–1.03)	0.632	0.07 ± 0.03	1.07 (1.01–1.14)	0.038
	Model 3
Age	0.07 ± 0.01	1.07 (1.04–1.10)	<0.001	0.03 ± 0.02	1.03 (0.99–1.07)	0.093
%Fat	0.07 ± 0.02	1.07 (1.03–1.12)	0.002	−0.001 ± 0.03	0.99 (0.95–1.05)	0.960
HGS	−0.008 ± 0.02	0.99 (0.95–1.03)	0.689	0.08 ± 0.03	1.08 (1.02–1.15)	0.024

Data are presented as β ± S.E and odds ratios (95% confidence intervals). p Value significant at 0.05 and 0.01 level.

HGS: hand grip strength; MetS: metabolic syndrome; BMI; body mass index; % fat: fat percentage

Data availability statement

All the associated data is available in the manuscript.