Exploring the relationship between grip strength and diabetic nephropathy among U.S. adults with type 2 diabetes mellitus: a cross-sectional NHANES analysis.

Abstract

Aim: To examine the relationship between grip strength (GS) and diabetic nephropathy (DN).

Materials and methods: Data on patients with type 2 diabetes mellitus collected between 2011 and 2014 were obtained from National Health and Nutrition Examination Survey (NHANES). Demographic characteristics (sex, age, race, marital status, and educational level), clinical measures (smoking status, drinking status, body mass index [BMI], glycated hemoglobin [HbA1c], urinary albumin creatinine ratio [UACR], diabetes duration, and hypertension), and grip strength assessments were collected. The relationship between GS and DN was analyzed using a logistic regression model. Subgroup analyses were showed as forest plots, conducted while accounting for confounding variables. Restricted cubic splines were applied to investigate nonlinear correlations. A sensitivity analysis was conducted to assess the robustness of the findings.

Results: This study included 1,539 participants. In the multivariate logistic regression model, the odds ratios (ORs) were 0.96 (95% CI, 0.94-0.98) in male and 0.94 (95% CI, 0.91-0.98) in female. Compared with those in the lowest quartiles, participants in the uppermost GS quartiles were less susceptible to DN in male [OR 0.35 (95% CI, 0.20-0.62)] and female [OR 0.37 (95% CI, 0.20-0.67)] (p for trend < 0.001). After adjusting for all variables, the ORs were 0.96 (95% CI, 0.94-0.98) in male and 0.94 (95% CI, 0.91-0.98) in female. Compared with those in the lowest quartiles, participants in the uppermost GS quartiles were less susceptible to DN in male [OR 0.35 (95% CI, 0.20-0.62)] (p for trend < 0.001) and female [OR 0.37 (95% CI, 0.20-0.67)] (p for trend < 0.001). Subgroup analysis demonstrated a reliable connection between GS and DN (all p for interaction > 0.05). We discovered a nonlinear relationship between GS and DN in both male and female participants (all p for nonlinearity < 0.05). More precisely, the data revealed L-shaped relationship and inverted-S relation in male and female participants, respectively.

Conclusion: The results of this cross-sectional study using NHANES data indicated a potential negative association between GS and DN. Additional extensive studies are necessary to elucidate these trends.