title: Muscle Weakness Is Associated With Diabetes in Older Mexicans: The Mexican Health and Aging Study.
abstract: The risk of cardiovascular problems due to diabetes mellitus is highest among older Mexicans, and yet what remains to be determined is the association between muscle weakness and diabetes in this population. Therefore, the purpose of this study was to determine the association between muscle strength and diabetes among Mexican adults greater than 50 years of age.
  
  
  
  Cross-sectional.
  
  
  
  National sample of households in both urban and rural areas.
  
  
  
  A subsample of 1841 individuals aged 50 years and older was included from the 2012 Mexican Health and Aging Study.
  
  
  
  Strength was assessed using a hand-held dynamometer, and the single largest reading from either hand was normalized to body mass (normalized grip strength [NGS]). Conditional inference tree analyses were used to identify sex-specific NGS weakness thresholds. Linear regression was used to examine the association between NGS and HbA1c, and logistic regression was used to assess the association between weakness and risk of diabetes (HbA1c ≥ 6.5% [≥48 mmol/mol]), after controlling for age, sex, and waist circumference.
  
  
  
  NGS was inversely associated with HbA1c (β = -1.56; P < .001). Optimal sex-specific NGS weakness thresholds to detect diabetes were ≤0.46 and ≤0.30 for men and women, respectively. Weakness was associated with significantly increased odds of diabetes (odds ratio, 1.69; 95% confidence interval, 1.37-2.10), even after adjusting for age, sex, and waist circumference.
  
  
  
  NGS was robustly associated with diabetes and other cardiometabolic risk factors in older Mexicans. This simple screen may serve as a valuable tool to identify adults that are at risk for negative health consequences or early mortality and who might benefit from lifestyle interventions to reduce risk.
authors.affiliation: Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: mdpeterz@med.umich.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Peterson
authors.affiliation: Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI.
authors.forename: Ryan
authors.initials: R
authors.lastname: McGrath
authors.affiliation: Department of Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX.
authors.forename: Kyriakos S
authors.initials: KS
authors.lastname: Markides
authors.affiliation: Division of Rehabilitation Sciences/School of Health Professions, Department of Internal Medicine/Division of Geriatrics, University of Texas Medical Branch, Galveston, TX.
authors.forename: Soham
authors.initials: S
authors.lastname: Al Snih
authors.affiliation: Sealy Center on Aging; Preventive Medicine & Community Health; WHO/PAHO Collaborating Center on Aging and Health, University of Texas Medical Branch, Galveston, TX.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Wong
mesh_terms: D000368:Aged; D000375:Aging; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D018908:Muscle Weakness
keywords: Insulin resistance; aging; diabetes; epidemiology; muscle weakness