ESPE Abstracts (2019) 92 RFC7.4

Handgrip Strength Correlates with Insulin Resistance and the Metabolic Syndrome in Children and Adolescents: Analysis of the Korean National Health and Nutrition Examination Survey 2014-2016

Hae Woon Jung1, Young Ah Lee2, Seong Yong Lee3, Choong Ho Shin2, Sei Won Yang2, Jae Hyun Kim4


1Kyunghee University Medical Center, Seoul, Korea, Republic of. 2Seoul National University Children's Hospital, Seoul, Korea, Republic of. 3Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea, Republic of. 4Seoul National University Bundang Hospital, Seongnam, Korea, Republic of


Introduction: Reduced muscle strength is associated with increased cardiometabolic morbidity and mortality. Handgrip strength (HGS) is an indicator of muscle strength and has been correlated with total muscle strength in children and adolescents. We aimed to evaluate the association between HGS and parameters of the metabolic syndrome and insulin resistance in children and adolescents.

Methods: A total of 2,242 children and adolescents (age 10-18) participated in the Korean National Health and Nutrition Examination Survey (KNHANES) between 2014 and 2016. Those 1,646 healthy children (884 males) with measurements of HGS, anthropometrics, and metabolic syndrome parameters were included. For analysis of insulin resistance, a subgroup of 555 children with fasting insulin levels were included. HGS was analyzed by the combined HGS (CHGS; the sum of the largest reading from each hand expressed in kilograms) and was further normalized for bodyweight (nCHGS).

Results: At a mean age of 14.4 ± 0.1 years, 198 (12.3%) participants were obese and 208 (12.9%) had abdominal obesity. The metabolic syndrome was present in 40 (2.4%) participants. The mean nCHGS was 0.95±0.01 kg/kg bodyweight. There was an increasing trend for abdominal obesity, elevated fasting glucose, hypertension, hypertriglyceridemia and low HDL with decreasing quartiles of nCHGS (P for trend < 0.05, for all). Presence of the metabolic syndrome was significantly increased with decreased nCHGS (P for trend < 0.05). Subgroup analysis of participants with insulin levels showed that nCHGS was significantly decreased in participants with increased insulin and HOMA-IR levels. The negative correlation of nCHGS with insulin (β -0.72, P < 0.001) and HOMA-IR (β -0.71, P < 0.001) remained significant after adjustment for sex, age, physical activity and sedentary time.

Conclusions: Normalized handgrip strength was significantly decreased in all parameters of the metabolic syndrome and insulin resistance. Normalized handgrip strength, a simple measure of muscular fitness, can be useful in predicting the presence of cardiometabolic risk factors in children and adolescents

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