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PURPOSE: We investigated whether relative handgrip strength (RHS) and change in handgrip strength predicted Type 2 DM incidence in middle-aged and older adults.METHODS: Total of 29,098 participants (8,609 men and 20,489 women) aged 40-69 who were free of diabetes at the baseline examination drawn from the Korean Genome and Epidemiology Study-Urban Health Examinees cohort (KoGES-HEXA), a large prospective population-based study. RHS was assessed with a dynamometer and divided by body mass index. Diabetes was defined as selfreported physician-diagnosed diabetes, use of anti-diabetic medications or measured fasting glucose ≥126 mg/dl, or glycated hemoglobin (HbA1C) ≥6.5%. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HRs) and 95% confidence intervals (CIs) of Diabetes incidences according to baseline RHS levels and RHS changes.RESULTS: During a mean follow-up period of 4 years (49.8±13.3 month), 1,167 (4.0%) participants developed diabetes. Compared with the high RHS group, higher risk of diabetes incidence was observed in low RHS group (men HR=1.28, 95% CI 1.06-1.55, women HR=1.32, 95% CI 1.12-1.54) after adjusted for age, triglyceride, cigarette smoking, alcohol consumption, marriage, income, education hypertension, family history of diabetes, fasting glucose, regular exercise. In addition, compared with the sustained high RHS group, sustained low RHS group showed an increased risk of diabetes incidence (men HR=1.60, 95% CI 1.28-2.00, women HR=1.85, 95% CI 1.52-2.24) after adjustment. However, the risk was not statistically significant in increased RHS group (men HR=0.98, 95% CI 0.73-1.31, women HR=1.11, 95% CI 0.85-1.43).CONCLUSIONS: The present findings indicate that RHS is independently associated with the risk of incident diabetes in middle and older adults. RHS measurement may be useful to identify individuals at increased risk for diabetes incidence. Maintaining a high level of RHS is important strategies for diabetes prevention among adults.

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Associations between Relative Handgrip Strength and Incidence of Type 2 Diabetes Mellitus in Middle-aged and Older adults: Finding from the Korean Genome and Epidemiology Study