Abstract
OBJECTIVES: This study examines the impact of absolute grip strength (AGS) and relative grip strength (RGS) on the risk of developing type 2 diabetes mellitus (DM), especially in relation to metabolic syndrome (MetS). METHODS: 1,935 participants were adults aged 51 to 81 years with an average observation period of 6.50 years. The diagnosis of DM was based on American Diabetes Association. The JAMA 5030J1 dynamometer was used to measure the grip strength. Multivariable extended Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for DM incidence. RESULTS: The DM risk increased with the number of MetS risk factors. High AGS was associated with a reduced DM risk (HR = 0.66, 95% CI = 0.44-0.99), but association disappeared when adjusted for MetS. High RGS was significantly associated with a reduced risk of DM incidence (HR = 0.49, 95% CI = 0.33-0.72), even after adjusting for MetS (HR = 0.63, 95% CI = 0.42-0.94). With the presence of MetS, higher AGS was associated with a greater increase in the DM risk compared to lower AGS, while higher RGS was associated with a less increase in the DM risk compared to lower RGS. CONCLUSION: This study demonstrates that RGS is a more reliable predictor of DM risks than AGS. Additionally, MetS significantly increases DM risk, particularly in individuals with obesity and hypertension. The study highlights the importance of assessing muscle quality in DM prevention and suggest that improving muscle quality may help mitigate DM risk.