title: Low Muscle Strength Thresholds for the Detection of Cardiometabolic Risk in Adolescents.
abstract: BACKGROUND
  There is an association between strength and health among adolescents, yet, what remains to be determined is sex-specific cut points for low strength in the detection of risk in this population. The purpose of this study was to determine thresholds of low grip strength in a large cohort (N=1,326) of adolescents.
  
  
  METHODS
  All data were collected between 2005 and 2008, and analyzed in 2014-2015. A cardiometabolic risk score (MetScore) was computed from the following components: percent body fat, fasting glucose, blood pressure, plasma triglyceride levels, and high-density lipoprotein cholesterol. A high-risk cardiometabolic phenotype was characterized as ≥75th percentile of the MetScore. Conditional inference tree analyses were used to identify sex-specific, low normalized strength (grip strength/body mass) thresholds and risk categories.
  
  
  RESULTS
  Lower strength was independently associated with increased odds of the high-risk cardiometabolic phenotype, such that for every 5% decrement of normalized strength, there were 1.48 and 1.45 increased odds (p<0.001) for boys and girls, even after adjusting for cardiorespiratory fitness and physical activity. Conditional tree analysis revealed a high-risk threshold for boys (≤0.33) and girls (≤0.28), as well as an intermediate threshold (boys, >0.33 and ≤0.45; girls, >0.28 and ≤0.36).
  
  
  CONCLUSIONS
  These sex-specific thresholds of low strength can be incorporated into a clinical setting for identifying adolescents that would benefit from lifestyle interventions to improve muscular fitness and reduce cardiometabolic risk.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Peterson
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Human Performance Laboratory, Central Michigan University, Mt. Pleasant, Michigan.
authors.forename: William A
authors.initials: WA
authors.lastname: Saltarelli
authors.affiliation: Exercise and Sport Performance Department, University of New England, Portland, Maine.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Visich
authors.affiliation: Department of Health, Human Performance and Recreation, Baylor University, Waco, Texas. Electronic address: paul_m_gordon@baylor.edu.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Gordon
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008019:Life Style; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000209:etiology; D010641:Phenotype; D010809:Physical Fitness / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors