Online first
Research paper
Published online: 2024-04-23

open access

Page views 80
Article views/downloads 41
Get Citation

Connect on Social Media

Connect on Social Media

Relative Handgrip Strength Positively Correlates with Low-Density Lipoprotein Cholesterol Level in Patients with Type 2 Diabetes: A Cross-Sectional Study

Shuichi Okada12, Yasuyo Nakajima3, Koji Kikkawa2, Atsushi Isoda1, Hiroto Hoshi1, Junichi Okada4, Kazuya Okada5, Tsugumichi Saito6, Eijiro Yamada6, Tetsuro Andou2, Kihachi Ohshima2


Objective: The aim of this clinical study was to discover a new factor affecting muscle strength and quality in patients with type 2 diabetes (T2D). Materials and methods: The relationship between muscle strength and quality and low-density lipoprotein cholesterol (LDL-C), random triglyceride (TG), and high-density lipoprotein cholesterol (HGL-C) levels were studied. Relative handgrip strength (RHGS) was used to evaluate muscular strength and quality. RHGS was calculated by dividing the absolute handgrip strength by body mass index (BMI). Using the stepwise method, multiple regression analysis was conducted and the linear correlation between variables was calculated by estimating Pearson correlation coefficient. Results: This study enrolled 68 patients with T2D. The majority of the participants were men, accounting for 71.5%. The median values of the measured parameters were as follows: age 67 years, physical activity
level 10.1 METs/h/week, estimated glomerular filtration rate 57.0 mL/min/1.73 m2, systolic blood pressure 123.5 mmHg, diastolic blood pressure 69.0 mmHg, body weight 64.1 kg, body mass index 24.35 kg/m2, HbA1c level 7.4%, random TG level 139 mg/dL, HDL-C level 52.5 mg/dL, and T2D duration 16.0 years. RHGS was 1.47 ± 0.40 kg/BMI. RHGS was associated with LDL-C (r = 0.349) but was not correlated with random TG and HDL-C (r = 0.124 and r = 0.088, respectively). Conclusions: Patients with T2D with better muscle strength and quality demonstrated an increased LDL-C
level. In patients with T2D, LDL-C may be a factor affecting muscle strength and quality.

Article available in PDF format

View PDF Download PDF file


  1. Festa A, Williams K, D'Agostino R, et al. The natural course of beta-cell function in nondiabetic and diabetic individuals: the Insulin Resistance Atherosclerosis Study. Diabetes. 2006; 55(4): 1114–1120.
  2. Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications. 2017; 31(9): 1465–1473.
  3. Kimm H, Lee SW, Lee HS, et al. Associations between lipid measures and metabolic syndrome, insulin resistance and adiponectin. - Usefulness of lipid ratios in Korean men and women -. Circ J. 2010; 74(5): 931–937.
  4. Nomura T, Ikeda Y, Nakao S, et al. Muscle strength is a marker of insulin resistance in patients with type 2 diabetes: a pilot study. Endocr J. 2007; 54(5): 791–796.
  5. Hirschler V, Maccallini G, Sanchez M, et al. Association between triglyceride to HDL-C ratio and insulin resistance in indigenous Argentinean children. Pediatr Diabetes. 2015; 16(8): 606–612.
  6. Ando T, Okada S, Niijima Y, et al. Impaired glucose tolerance, but not impaired fasting glucose, is a risk factor for early-stage atherosclerosis. Diabet Med. 2010; 27(12): 1430–1435.
  7. Bayoumi RAL, Khamis AH, Tahlak MA, et al. Utility of oral glucose tolerance test in predicting type 2 diabetes following gestational diabetes: Towards personalized care. World J Diabetes. 2021; 12(10): 1778–1788.
  8. Cha RH, Lee GS, Yoo JuY, et al. Hand Grip and Leg Muscle Strength in Hemodialysis Patients and Its Determinants. J Korean Med Sci. 2021; 36(11): e76.
  9. Hong S. Association of Relative Handgrip Strength and Metabolic Syndrome in Korean Older Adults: Korea National Health and Nutrition Examination Survey VII-1. J Obes Metab Syndr. 2019; 28(1): 53–60.
  10. Kawamoto R, Ninomiya D, Kasai Y, et al. Handgrip strength is associated with metabolic syndrome among middle-aged and elderly community-dwelling persons. Clin Exp Hypertens. 2016; 38(2): 245–251.
  11. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39(4): 412–423.
  12. Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15(2): 95–101.
  13. Studenski SA, Peters KW, Alley DE, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014; 69(5): 547–558.
  14. Chen LK, Lee WJ, Peng LN, et al. Asian Working Group for Sarcopenia. Recent Advances in Sarcopenia Research in Asia: 2016 Update From the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2016; 17(8): 767.e1–767.e7.
  15. Choquette S, Bouchard DR, Doyon CY, et al. Relative strength as a determinant of mobility in elders 67-84 years of age. a nuage study: nutrition as a determinant of successful aging. J Nutr Health Aging. 2010; 14(3): 190–195.
  16. Yi DW, Khang AhR, Lee HW, et al. Relative handgrip strength as a marker of metabolic syndrome: the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2014-2015). Diabetes Metab Syndr Obes. 2018; 11: 227–240.
  17. Lawman HG, Troiano RP, Perna FM, et al. Associations of Relative Handgrip Strength and Cardiovascular Disease Biomarkers in U.S. Adults, 2011-2012. Am J Prev Med. 2016; 50(6): 677–683.
  18. Lee WJ, Peng LN, Chiou ST, et al. Relative Handgrip Strength Is a Simple Indicator of Cardiometabolic Risk among Middle-Aged and Older People: A Nationwide Population-Based Study in Taiwan. PLoS One. 2016; 11(8): e0160876.
  19. Authors/Task Force Members, ESC Committee for Practice Guidelines (CPG), ESC National Cardiac Societies. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019; 290: 140–205.