Associations between diabetes and both cardiovascular disease and all-cause mortality are modified by grip strength: evidence from UK Biobank, a prospective population-based cohort study

Celis-Morales, C. A. et al. (2017) Associations between diabetes and both cardiovascular disease and all-cause mortality are modified by grip strength: evidence from UK Biobank, a prospective population-based cohort study. Diabetes Care, 40(12), pp. 1710-1718. (doi:10.2337/dc17-0921) (PMID:28986505)

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Abstract

OBJECTIVE Grip strength and diabetes are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to predispose to adverse health outcomes is unknown. This study determined the interactions between diabetes and grip strength and their association with health outcomes. RESEARCH DESIGN AND METHODS We undertook a prospective, general population cohort study by using UK Biobank. Cox proportional hazards models were used to explore the associations between both grip strength and diabetes and the outcomes of all-cause mortality and CVD incidence/mortality as well as to test for interactions between diabetes and grip strength. RESULTS 347,130 UK Biobank participants with full data available (mean age 55.9 years, BMI 27.2 kg/m2, 54.2% women) were included in the analysis, of which 13,373 (4.0%) had diabetes. Over a median follow-up of 4.9 years (range 3.3–7.8 years), 6,209 died (594 as a result of CVD), and 4,301 developed CVD. Participants with diabetes were at higher risk of all-cause and CVD mortality and CVD incidence. Significant interactions (P < 0.05) existed whereby the risk of CVD mortality was higher in participants with diabetes with low (hazard ratio [HR] 4.05 [95% CI 2.72, 5.80]) versus high (HR 1.46 [0.87, 2.46]) grip strength. Similar results were observed for all-cause mortality and CVD incidence. CONCLUSIONS Risk of adverse health outcomes among people with diabetes is lower in those with high grip strength. Low grip strength may be useful to identify a higher-risk subgroup of patients with diabetes. Intervention studies are required to determine whether resistance exercise can reduce risk.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Celis, Dr Carlos and Gray, Dr Stuart and Gill, Professor Jason and Welsh, Dr Paul and Anderson, Dr Jana and Iliodromiti, Dr Stamatina and Pell, Professor Jill and McLaren, Dr James and Mackay, Dr Daniel and Petermann, Mrs Fanny and Sattar, Professor Naveed and Lyall, Dr Donald
Authors: Celis-Morales, C. A., Petermann, F., Hui, L., Lyall, D. M., Iliodromiti, S., McLaren, J., Anderson, J., Welsh, P., Mackay, D. F., Pell, J. P., Sattar, N., Gill, J. M.R., and Gray, S. R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Diabetes Care
Publisher:American Diabetes Association
ISSN:0149-5992
ISSN (Online):1935-5548
Published Online:06 October 2017
Copyright Holders:Copyright © 2017 The AuthorsAmerican Diabetes Association
First Published:First published in Diabetes Care 40(12):1710-1718
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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