Associations between handgrip strength and skeletal muscle mass with all‐cause mortality and cardiovascular mortality in people with type 2 diabetes: A prospective cohort study of the UK Biobank

Abstract

AbstractAimsTo explore the associations between handgrip strength (HGS) and skeletal muscle mass (SMM) with all‐cause and cardiovascular disease (CVD) mortality risk in type 2 diabetes (T2DM) patients.Materials and MethodsData were obtained from the UK Biobank. Baseline survey was conducted between 2006 and 2010, and followed up for a median of 12.52 years. HGS was measured using dynamometer, and SMM was measured using bioelectrical impedance method. Mortality was available via links to the National Health Service Information Centre. Sex‐specific analyses were conducted.ResultsA total of 13 392 T2DM participants were included, with a mean age of 60.39 years and 52.35% men. During the follow‐up, there were 3006 (22.45%) deaths, including 746 (5.57%) CVD deaths. The risk for all‐cause mortality and CVD mortality among both men and women increased progressively with decreasing HGS quartiles (p trend <.05). A 1 SD decrease in HGS was found to both increase the all‐cause risk (HR: 1.31 [95% CI: 1.24–1.38]) and CVD mortality risk (HR: 1.35 [95% CI: 1.22–1.50]) for men, and all‐cause risk (HR: 1.26 [95% CI: 1.11–1.42]) and CVD mortality risk (HR: 1.43 [95% CI: 1.09–1.89]) for women. There was no statistically significant trend association between SMM/height2 and mortality risk, and the restricted cubic regression splines indicated that SMM/height2 showed a U‐shaped nonlinear relationship (pnonlinear <.05).ConclusionsGrip strength displayed a linear downward trend with mortality risk among T2DM patients, whereas muscle mass showed a U‐shaped relationship. Low grip strength seemed to be a better predictor for mortality compared to low muscle mass.