The association between grip strength and incident carotid atherosclerosis in middle-aged and older adults: The TCLSIH cohort study

Objectives: Atherosclerosis has become a leading public health problem. Previous studies suggest that enhanced muscle strength and muscle-derived cytokines (myokines) are linked with atherosclerosis. However, no previous prospective study has examined the relationship between grip strength (GS) and carotid atherosclerosis (CAS) in middle-aged and older adults. We therefore designed a cohort study to investigate the association between GS and the incidence of CAS in a population aged 45 years and over.Methods: The cohort study (n = 1258; follow-up range: 1-6 years, median: 4.0 years, age range: 45-85 years) was performed from 2013 to 2019 in Tianjin, China. CAS was measured using a carotid artery B-mode ultrasound system and defined by increased carotid intima-media thickness and plaques. GS was measured using a handheld digital dynamometer. Adjusted Cox proportional hazards regression models were used to assess the association between quartiles of GS and CAS.Results: The incidence of CAS was 122 cases per 1000 person-years. In the final multivariable models, the adjusted hazard ratios (HRs) [95 % confidence interval (CI)] for CAS across quartiles of weight-adjusted GS (Q1 -Q4) were as follows: 1.00 (reference), 0.82 (0.63, 1.06), 0.92 (0.71, 1.19), 0.69 (0.52, 0.91) and the HRs (95 % CI) across quartiles of GS (Q1-Q4) were as follows: 1.00 (reference), 1.06 (0.83, 1.36), 0.78 (0.59, 1.02), 0.76 (0.58, 0.995). For one unit and one standard deviation (SD) increase in weight-adjusted GS, the adjusted HRs (95 % CI) of CAS were 0.16 (0.05, 0.52) and 0.82 (0.72, 0.93), respectively. For one unit and one SD increase in GS, the adjusted HRs (95 % CI) of CAS were 0.98 (0.96, 0.995), and 0.47 (0.26, 0.83), respectively.Conclusions: Higher GS was associated with a lower incidence of carotid atherosclerosis in middle-aged and older adults. Further studies are required to clarify the causality.