Handgrip Strength and Trajectories of Preclinical Obesity Progression: A Multistate Model Analysis Using the UK Biobank

作者：Ming Xu, Menghan Li, Yawen Zhang, Lianxi Li, Yun Shen, Gang Hu · 发表于：The Journal of Clinical Endocrinology & Metabolism · 年份：2025 · DOI：10.1210/clinem/dgaf521 · 被引用次数：2 · 研究领域：Nutrition and Health in Aging、Cardiovascular Function and Risk Factors、Frailty in Older Adults

PURPOSE: Grip strength has been increasingly recognized as a predictor of chronic disease risk and mortality. The aim of our study was to investigate the association of grip strength and the trajectories of preclinical obesity progression. METHODS: Data were collected from 93 275 participants in the UK Biobank. Preclinical obesity was diagnosed based on an excess of anthropometric parameters, defined as elevated body mass index combined with at least 1 abnormal measure among waist circumference, waist-to-hip ratio, waist-to-height ratio, or percentage body fat, in the absence of obesity-induced dysfunctions. Three models captured different trajectories from baseline to dysfunctions and death, with or without intermediate progression. A multistate model was used to investigate the association between grip strength and the preclinical obesity progression and multiple-cause mortality risk. Sensitivity analyses were performed using free muscle volume, total lean mass, and muscle-to-weight ratio as exposures. RESULTS: Among 8163 death events over a mean follow-up of 13.4 years, each SD increase in grip strength was associated with a significantly reduced risk of preclinical obesity progression at each stage, with the strongest inverse association observed in baseline to first dysfunction [fully adjusted hazard ratio (HR): 0.86, 95% confidence interval (CI): 0.85-0.88]. Compared to the lowest tertile, the highest grip strength significantly showed protective effects across all traj...