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. 2021 Dec;12(6):2091-2100.
doi: 10.1002/jcsm.12816. Epub 2021 Oct 3.

Between-study differences in grip strength: a comparison of Norwegian and Russian adults aged 40-69 years

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Between-study differences in grip strength: a comparison of Norwegian and Russian adults aged 40-69 years

Rachel Cooper et al. J Cachexia Sarcopenia Muscle. 2021 Dec.

Abstract

Background: Identifying individuals with low grip strength is an initial step in many operational definitions of sarcopenia. As evidence indicates that contemporaneous Russian populations may have lower mean levels of grip strength than other populations in northern Europe, we aimed to: compare grip strength in Russian and Norwegian populations by age and sex; investigate whether height, body mass index, education, smoking status, alcohol use and health status explain observed differences and; examine implications for case-finding low muscle strength.

Methods: We used harmonized cross-sectional data on grip strength and covariates for participants aged 40-69 years from the Russian Know Your Heart study (KYH) (n = 3833) and the seventh survey of the Norwegian Tromsø Study (n = 5598). Maximum grip strength (kg) was assessed using the same protocol and device in both studies. Grip strength by age, sex and study was modelled using linear regression and between-study differences were predicted from these models. Sex-specific age-standardized differences in grip strength and in prevalence of low muscle strength were estimated using the European population standard of 2013.

Results: Normal ranges of maximum grip strength in both studies combined were 33.8 to 67.0 kg in men and 18.7 to 40.1 kg in women. Mean grip strength was higher among Tromsø than KYH study participants and this difference did not vary markedly by age or sex. Adjustment for covariates, most notably height, attenuated between-study differences but these differences were still evident at younger ages. For example, estimated between-study differences in mean grip strength in fully adjusted models were 2.2 kg [95% confidence interval (CI) 1.4, 3.1] at 40 years and 1.0 kg (95% CI 0.5, 1.5) at 65 years in men (age × study interaction P = 0.09) and 1.1 kg (95% CI 0.4, 1.9) at age 40 years and -0.2 kg (95% CI -0.7, 0.3) at 65 years in women (age × study interaction P < 0.01).

Conclusions: We found between-study differences in mean grip strength that are likely to translate into greater future risk of sarcopenia and poorer prospects of healthy ageing for Russian than Norwegian study participants. For example, the average Russian participant had a similar level of grip strength to a Norwegian participant 7 years older. Our findings suggest these differences may have their origins in childhood highlighting the need to consider interventions in early life to prevent sarcopenia.

Keywords: Between-country differences; Body size; Grip strength; Lifestyle; Sarcopenia.

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Conflict of interest statement

None of the authors have any conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mean grip strength (kg) (95% confidence intervals) by age and study in men and women. Estimated in sex‐specific linear regression models including age, study, and an age by study interaction (N = 9431). *Dots are unadjusted observed means (blue for Tromsø 7 and red for Know Your Heart Study)
Figure 2
Figure 2
Absolute differences in mean grip strength (kg) (95% confidence intervals) between Know Your Heart and Tromsø 7 study participants by age and sex estimated in linear regression models with and without adjustments for covariates (Tromsø 7 is the reference line at 0) (N = 8965). Footnotes: In all models, age is modelled linearly including all its three‐ways and two‐ways interactions with study and sex. Fully adjusted model includes: eight, body mass index, education, smoking status, alcohol use and health status (indicated by presence or absence of self‐reported myocardial infarction/heart attack or stroke; arthritis or osteoarthritis; diabetes). P values presented are from tests of interaction between age and study.

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