Short ReportLower grip strength in youth with obesity identifies those with increased cardiometabolic risk
Introduction
Low hand grip strength is associated with cardiovascular disease and all-cause mortality in adults [1]. In children and adolescents it is an independent predictor of concurrent and future risk factors for cardiometabolic disease (cardiovascular disease and type 2 diabetes) [2], [3]. Recently, sex-specific thresholds for low grip strength have been proposed to detect cardiometabolic risk in youth [2]. The utility of these thresholds to discern increased cardiometabolic risk among youth with obesity has not been examined.
We used data from the Childhood Overweight BioRepository of Australia (COBRA). Our aim was to examine the association between low grip strength with cardiometabolic risk factors and preclinical markers of vascular and metabolic health.
Section snippets
Methods
Children and adolescents were recruited into the COBRA from the Royal Children's Hospital (Melbourne, Australia) Weight Management Service as previously described [4]. The sample comprised 43 youth with obesity aged 8–19 years already enrolled in COBRA who participated in a cardiovascular risk sub-study when data on grip strength and markers of cardiovascular health were collected. Informed, written consent was obtained from the participant or their legal guardian for those aged < 18 years. The
Results
Participant characteristics are displayed in Table 1. On average, participants had a BMI z-score of 2.53, a body fat percentage of 44, a waist circumference of 109 cm, and a maximum grip strength of 32 kg. Only 4 participants (9.3 %) had a high normalized grip strength. Mean levels of cardiometabolic risk factors according to normalized grip strength categories (moderate/high vs low) are shown in Table 2. In general, participants with low normalized grip strength had poorer cardiometabolic risk
Discussion
We observed that low normalized grip strength can identify obese youth who have increased cardiometabolic risk. Youth with low normalized grip strength had higher systolic blood pressure, LDL-cholesterol, MetS score, and cIMT, compared with those with moderate/high grip strength.
Previously, Melo et al. [16] demonstrated that grip strength was associated with cIMT in healthy weight children aged 11–12 years. We extend this finding by showing an inverse association of normalized grip strength and
Ethics
The authors declare that all experiments on human subjects were conducted in accordance with the Declaration of Helsinki, and that all procedures were carried out with the adequate understanding and written consent of the subjects.
The authors also certify that formal approval to conduct the experiments described has been obtained from the human subjects review board of their institution and could be provided upon request.
Financial disclosure
There are no financial relationships relevant to this article to disclose.
Conflict of interest
The authors declare no potential conflicts of interest, including no specific financial interests relevant to the subject of this manuscript.
Acknowledgements
TTL was supported by Maud Kuistila Foundation, Finnish Foundation for Cardiovascular Research, Finnish Medical Foundation, and Turku University Foundation. CS was supported for a one year clinical research fellowship position at the Endocrinology Department at the Royal Children's Hospital by “Batzebaer Foundation”, Inselspital Bern; “Fondazione Ettore e Valeria Rossi”; “Freie akademische Gesellschaft Basel” and “NovoNordisk”, all Switzerland. JN was supported by Juho Vainio Foundation, Finnish
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These authors contributed equally to the work.