Handgrip strength thresholds to detect cardiometabolic risk in youth: cross-sectional study and meta-analysis
Background Muscular fitness, particularly handgrip strength, is increasingly recognized as a robust marker of cardiometabolic risk (CMR) in children and adolescents. However, evidence-based diagnostic thresholds for identifying at-risk individuals remain scarce, particularly in children. This study...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad Pública de Navarra |
| Repositorio: | Academica-e. Repositorio Institucional de la Universidad Pública de Navarra |
| OAI Identifier: | oai:academica-e.unavarra.es:2454/55873 |
| Acceso en línea: | https://hdl.handle.net/2454/55873 |
| Access Level: | acceso abierto |
| Palabra clave: | Cut-off Grip strength Metabolic syndrome Receiver operating characteristic curves |
| Sumario: | Background Muscular fitness, particularly handgrip strength, is increasingly recognized as a robust marker of cardiometabolic risk (CMR) in children and adolescents. However, evidence-based diagnostic thresholds for identifying at-risk individuals remain scarce, particularly in children. This study aimed to (1) establish sex-specific diagnostic thresholds for handgrip strength normalized to body weight to identify elevated CMR in children aged 8–11 years, and (2) synthesize existing evidence through a systematic review and meta-analysis across pediatric age groups, integrating the new data with existing evidence. Methods We analyzed cross-sectional data from 1124 Spanish children (49.7% girls) aged 8–11 years participating in the MOVI-2 study. Normalized handgrip strength was associated with a CMR index composed of waist circumference, triglyceride-to-HDL ratio, mean arterial pressure and fasting insulin. Diagnostic accuracy was assessed using receiver operating characteristic curves and optimized with the Youden Index. Results from the MOVI-2 study and other diagnostic accuracy studies were combined in a meta-analysis for identifying the optimal threshold for normalized handgrip strength to identify elevated CMR in youth. Results In the MOVI-2 study, thresholds were 0.38 for boys and 0.34 for girls, with area under the curve (AUC) of 0.77 (95% CI: 0.73–0.81) and 0.75 (95% CI: 0.70–0.79), respectively. The systematic review and meta-analysis followed PRISMA-DTA guidelines and included nine additional studies (n = 10 588). Meta-analytic thresholds for normalized handgrip strength were 0.30 for girls and 0.39 for boys in childhood (6–12 years), and 0.36 for girls and 0.42 for boys in adolescence (13–18 years), with the highest diagnostic accuracy observed in adolescent girls (AUC = 0.80, 95% CI: 0.77–0.83; Youden Index = 0.60). Children showed greater heterogeneity, particularly in specificity. Conclusions Despite certain limitations, our findings provide clinically relevant, sex- and age-specific thresholds for normalized handgrip strength to identify elevated CMR in youth. These thresholds may serve as a valuable starting point for CMR screening in both boys and girls. |
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