title: Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults.
abstract: BACKGROUND
  Muscle strength may play a role in cardiometabolic disease. We examined the relationship between hand grip strength and diabetes and hypertension in a sample of healthy weight adults.
  
  
  METHODS
  In 2015, we analyzed the National Health and Nutrition Examination Survey 2011-2012 for adults aged ≥20 years with healthy BMIs (between 18.5 and <25) and no history of cardiovascular disease (unweighted n=1,467; weighted n=61,587,139). Hand grip strength was assessed with a dynamometer. Diabetes was based on hemoglobin A1c level and reported diabetes diagnosis. Hypertension was based on measured blood pressure and reported hypertension diagnosis.
  
  
  RESULTS
  Individuals with undiagnosed diabetes compared with individuals without diabetes had lower grip strength (51.9 vs 69.8, p=0.0001), as did individuals with diagnosed diabetes compared with individuals without diabetes (61.7 vs 69.8, p=0.008). Mean grip strength was lower among individuals with undiagnosed hypertension compared with individuals without hypertension (63.5 vs 71.5, p=0.008) as well as among individuals with diagnosed hypertension compared with those without hypertension (60.8 vs 71.5, p<0.0001). In adjusted analyses controlling for age, sex, race, smoking status, and first-degree relative with disease, mean grip strength was lower for undiagnosed diabetes (β=-10.02, p<0.0001) and diagnosed diabetes (β=-8.21, p=0.03) compared with individuals without diabetes. In adjusted analyses, grip strength was lower among individuals with undiagnosed hypertension (β=-6.6, p=0.004) and diagnosed hypertension (β=-4.27, p=0.04) compared with individuals without hypertension.
  
  
  CONCLUSIONS
  Among healthy weight adults, combined grip strength is lower in individuals with diagnosed and undiagnosed diabetes and hypertension.
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida; Department of Family and Community Medicine, University of Florida, Gainesville, Florida;. Electronic address: arch.mainous@ufl.edu.
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Tanner
authors.affiliation: Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Anton
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida.
authors.forename: Ara
authors.initials: A
authors.lastname: Jo
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers