title: Muscle strength differ between patients with diabetes and controls following heart surgery.
abstract: The aim of our study was to analyze muscle strength in patients with recent surgical treatment for ischemic and combined ischemic-valvular heart disease, based on existence of diabetes mellitus. Connections existing between muscle strength and patient characteristics or conventional diagnostic tests were analyzed as well.
  
  
  
  Study prospectively included consecutive patients scheduled for cardiovascular rehabilitation 0-3months after heart surgery. Diagnostics covered drug utilization, anthropometrics, demographics, echocardiography, conventional laboratory, echocardiography, bioelectrical impedance analysis (BIA), and hand grip test (HGT). HGT was analyzed for dominant hand.
  
  
  
  Patients with diabetes had significantly weaker muscle strength on HGT than controls; 29.4±12.2kg vs. 38.2±14.7kg (p=0.029), respectively. ROC analysis for HGT and existence of diabetes mellitus were significant; ≤40kg had sensitivity of 89.7% (95%CI: 72.6-97.8), specificity 43.7% (31.9-56.0); AUC 0.669 (0.568-0.760); p=0.002. HGT significantly correlated with hematocrit (Rho CC=0.247; p=0.013), whilst other laboratory or echocardiographic parameters were insignificant (all p>0.05). HGT also correlated with body weight (Rho CC=0.510; p<0.001); height (Rho CC=0.632; p<0.001); waist circumference (Rho CC=0.388; p<0.001); waist-to-hip ratio (Rho CC=0.274; p=0.006) and BIA (Rho CC=-0.412; p<0.001).
  
  
  
  In postoperative recovery of patients with diabetes, muscle strength assessed by HGT is decreased and in relation with nutritional status. Clinically resourceful connections of HGT were also found to hematocrit and utilization of loop diuretics.
authors.affiliation: Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia; Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia. Electronic address: marcoboban@yahoo.com.
authors.forename: Marko
authors.initials: M
authors.lastname: Boban
authors.affiliation: Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia.
authors.forename: Mijana
authors.initials: M
authors.lastname: Barisic
authors.affiliation: Department of Cardiology, University Hospital "Thalassotherapia Opatija", Medical Faculty University of Rijeka, Croatia; Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia.
authors.forename: Viktor
authors.initials: V
authors.lastname: Persic
authors.affiliation: Department of Cardiology, County Hospital "Zadar", Croatia.
authors.forename: Drazen
authors.initials: D
authors.lastname: Zekanovic
authors.affiliation: Department of Cardiac Surgery, Medical Faculty University of Rijeka, University Hospital Centre "Rijeka", Croatia.
authors.forename: Igor
authors.initials: I
authors.lastname: Medved
authors.affiliation: Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia.
authors.forename: Marinko
authors.initials: M
authors.lastname: Zulj
authors.affiliation: Department of Internal Medicine, Medical Faculty "J.J. Strossmayer" University of Osijek, Croatia.
authors.forename: Aleskandar
authors.initials: A
authors.lastname: Vcev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D000072038:Cardiac Rehabilitation; D006348:Cardiac Surgical Procedures; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D055105:Waist Circumference; D049629:Waist-Hip Ratio
keywords: Diabetes mellitus; Hand grip test (HGT); Ischemic heart disease; Metabolism; Muscle strength; Valvular heart disease