Grip Strength Research Articles

Genetic Association Between Attention-Deficit/Hyperactivity Disorder and Sarcopenia: A Bidirectional Two-Sample, Two-Step Mendelian Randomized Study

Objective Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents, often accompanied by motor function disorders. Sarcopenia not only has skeletal muscle dysfunction but also has neurocognitive dysfunction. At present, there is no research to explore the relationship between ADHD and skeletal muscle function. The purpose of this study is to explore whether there is a causal effect between ADHD and sarcopenia.Methods In this study, genome-wide association study data of ADHD, appendicular lean mass (ALM), hand grip strength, and walking pace (WP) were extracted from public databases. The bidirectional two-sample Mendelian randomization (MR) method was employed to investigate the correlation between ADHD and sarcopenia-related indicators, and the inverse-variance weighted analysis as the primary analysis method.Results Based on the forward MR analysis, a potential causal relationship exists between ADHD and ALM (odds ratio [OR]=1.020, 95% confidence interval [CI]: 1.012–1.029, p<0.001). The reverse MR analysis indicates a link between WP and the risk of ADHD (OR=2.712, 95% CI: 1.609–4.571, p<0.001), with an accelerated WP increasing the likelihood of ADHD. Nevertheless, other MR analysis results did not show significant differences.Conclusion The findings of this study indicate an intricate causal relationship between ADHD and sarcopenia, suggesting the absence of a clear link. WP may be used as one of the indicators to evaluate the risk of ADHD. At the same time, we should pay more attention to the ALM of ADHD patients.

Low-level laser therapy and Graston technique on recurrence rate of palmar fibromatosis post percutaneous needle fasciotomy

Purpose. To investigate the effect of Graston technique and low-level laser therapy (LLLT) on the recurrence rate of palmar fibromatosis after the percutaneous needle fasciotomy (PNF) procedure. Material and methods. In a randomized controlled trial, 120 patients of both genders, aged 45 to 70 years, were divided into four equal groups of 30 patients each. All participants were diagnosed with stage 2 palmar fibromatosis and underwent surgical release (PNF). Treatment began 5 days post-surgery. Group A received LLLT and the Graston technique in addition to a traditional physical therapy program (ultrasound, hand grip strengthening exercises, night splint) for six weeks, with 18 sessions provided every other day (3 sessions per week). Group B received the Graston technique plus a traditional physical therapy program for six weeks. Group C received LLLT plus a traditional physical therapy program for six weeks. Group D received only the traditional physical therapy program for six weeks. Measurements were conducted using the modified Quick DASH and hand grip assessments before and after the six-week treatment period, as well as evaluations of recurrence rates at 6, 12, and 18 months following the conclusion of the treatment. Results. Post-treatment comparative analysis across the four groups revealed statistically significant outcomes, with all groups showing notable reductions in Quick DASH scores and significant improvements in hand grip strength (p < 0.01). Detailed intergroup evaluations demonstrated that Group A exhibited superior improvements compared to groups B, C, and D, while Group B showed significant enhancements relative to groups C and D. No substantial differences were noted between groups C and D. Additionally, groups A and B showed significantly lower recurrence rates of palmar fibromatosis at 6, 12, and 18 months compared to groups C and D (p < 0.001). Conclusions. The combined effect of the Graston technique with LLLT and a traditional program significantly reduces the recurrence rate of palmar fibromatosis compared to the other groups, alongside improvements in hand grip strength and reductions in modified Quick DASH scores.

Structural alterations during fracture healing lead to void spaces developing in surrounding bone microarchitecture.

Distal radius fractures are among the most common fracture sites, with a high incidence across all age groups. High-resolution peripheral quantitative computed tomography (HR-pQCT) has enabled assessment of bone microarchitecture in vivo at the distal radius, providing new insights into the healing process. However, we have observed structural bone loss that is not captured by standard analysis. This study uses void space analysis to quantify development of localized structural bone loss during fracture healing. Twenty-six participants (21 female, 5 male, aged 18-79years) with conservatively-treated distal radius fractures were scanned using HR-pQCT at 6 study visits post-fracture (weeks 1, 3, 5, 12, 26, and 52). Total BMD (Tt.BMD), bone volume fraction (BV/TV), and void space volume fraction (VS/TV) were measured. Grip strength relative to the non-fractured wrist and Patient Rated Wrist Evaluation (PRWE) were measured at all study visits after cast removal. The cumulative expansion of VS/TV across sequential study visits was quantified to differentiate voids that developed during healing from pre-existing void space. A five-fold increase in median VS/TV was observed during the follow-up period, from 1.0% (0.6-9.0%) to 5.5% (2.5-12.4%). Tt.BMD and BV/TV did not significantly change in this same time interval. Relative grip strength after cast removal was significantly inversely correlated with final VS/TV (⍴ = -0.63, p=.02) and cumulative expansion of new void space during healing (R = -0.67, p<.01), whereas no significant associations were found with age or PRWE. This study suggests that there are adverse changes in bone microarchitecture during fracture healing, despite the preservation of overall Tt.BMD and BV/TV in the same region. Reduced grip strength is correlated with more severe void space formation, but the mechanistic relationship requires further exploration. The formation of void spaces may have long-term implications on bone strength and could provide insight into risk of re-fracture.

Psychophysiological effects of a supervised home-based resistance band exercise program in pre-frail older patients with type 2 diabetes mellitus: a randomized controlled trial

BackgroundFrailty is a syndrome as with aging in the population of type 2 diabetes mellitus (T2DM) and exercise has become an essential non-pharmacological tool especially in the pre-frail stage. Notably, the form of supervised home-based exercise program has been strongly recommended in recent years. This study aimed to verify the potential effects of the supervised home-based elastic band exercise in pre-frail older T2DM patients in China.MethodsA total of 100 participants were included and randomly divided into intervention group (IG) (n = 50) and control group (CG) (n = 50). The CG received a routine care, while the IG received an extra home-based elastic band training under online and offline supervisions sustaining 12-weeks. The glycosylated hemoglobin (HbA1c), blood lipids, body composition, physical function, scales of Diabetes specificity quality of life scale (DSQL), Pittsburgh sleep quality index (PSQI) and short form geriatric depression scale (GDS-15) of the participants were evaluated before and after intervention.ResultsThe average age of the participants were 66.01 ± 4.76 with 55% male and average BMI 24.75 ± 3.51 kg/m2. The clinical characteristics of the two groups were comparable. After 12 weeks’ training, muscle mass of the limbs (P < 0.05), physical function indicators including grip strength, chair stands (both P < 0.05), walking time (P < 0.01), HbA1c (P < 0.05), frailty score (P < 0.05), subjective sleep quality (P < 0.05), total DSQL scores (P < 0.01) and the depressive status (P < 0.01) improved significantly in IG when compared with CG.ConclusionSupervised home-based elastic band exercise could improve limb muscle mass, physical fitness, glucose and lipid control and quality of life in pre-frail older T2DM patients.Trial registration numberChiCTR2300070726; Registration date: 21/04/2023.

Association of handgrip strength weakness and asymmetry with cognitive impairment and depressive symptoms in older Chinese adults

This study investigated the association between handgrip strength (HGS) asymmetry and weakness with cognitive function and depressive symptoms among 920 community-dwelling adults aged above 60 years in suburban Shanghai. Participants were selected using a multistage cluster-stratified sampling approach. Assessments included HGS measured with a dynamometer, the Montreal Cognitive Assessment (MoCA) for cognition, and the Geriatric Depression Scale (GDS) for depressive symptoms. Restricted cubic splines revealed a positive association between dominant HGS and MoCA scores, indicating better cognitive performance, and a negative association with GDS scores, suggesting fewer depressive symptoms. The association between the HGS ratio and MoCA scores and the HGS ratio and GDS scores varied by sex. Women with HGS weakness alone (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.37), asymmetry alone (OR = 1.93, 95% CI = 1.14–3.29), or weakness and asymmetry together (OR = 2.57, 95% CI = 1.48–4.46) had a significantly increased risk of cognitive impairment. However, no such associations observed in men. These findings suggest that HGS weakness and asymmetrical HGS may be associated with a higher risk of cognitive decline and depressive symptoms, particularly in women. This study emphasizes the need for sex-specific assessments and prevention strategies to address cognitive and mental health issues among older adults.

The relationship between age related changes in strength and fitness with body size, shape and composition

Handgrip strength (HGS), cardiorespiratory fitness (CRF) and body size, shape, and composition are all related to cardiometabolic health and are associated in cross-sectional settings. Their longitudinal relationship is less clear. We used observational data from the Study of Health in Pomerania at baseline (SHIP-TREND-0; 2008–2012) and follow-up (SHIP-TREND-1; 2016–2019) with 1,214 men and 1,293 women. HGS was measured with a hand dynamometer. CRF was assessed using cardiopulmonary exercise testing. Linear regression models were adjusted appropriately. Several sensitivity analyses were performed. From baseline to follow-up (7 years) HGS decreased in men (3.5 kg) and women (0.8 kg). VO2peak lessened in men (36 ml/min) and increased in women (53 ml/min). We only found significant relations in men where a 1 l decline in VO2peak was associated with a 0.87 kg larger decrease in fat free mass and with a 1.15 kg stronger decline in body weight. All other analysis revealed non-significant findings. This longitudinal analysis suggests that age related changes in strength and CRF are not related to body size and shape but only composition (in men). A novelty of our findings are the sex-specific aspects given that strength decreased much stronger in men compared to women.

Resistance-based exercise intervention for patients with coronary artery disease and sarcopenia: A pilot randomized controlled trial.

Sarcopenia is a prominent prognostic indicator in patients with coronary artery disease (CAD). This study aimed to examine the feasibility and preliminary effects of a resistance-based exercise intervention in CAD patients with sarcopenia. This pilot assessor-blinded two-arm randomized controlled trial recruited 40 CAD patients aged ≥60 years with sarcopenia (mean age: 69.1 ± 5.03 years; 52.5% male), assigning them in a 1:1 ratio to either usual care or a 12-week exercise intervention (60 minutes/session, 2 sessions/week). The intervention followed an individualized, progressive, resistance-based exercise protocol using easily accessible exercise equipment. A blended approach, including center-based, home-based and online sessions, was adopted to improve compliance and sustain training effects. No serious adverse events were reported, and the overall attendance rate was 94%. Compared with the control group, the intervention group showed significantly better physical performance measured by the Short Physical Performance Battery (β = 0.522, 95% CI = -2.712 to -0.665, p = 0.001, Hedges' g = 0.637) and muscle strength measured by handgrip strength (β = -2.435, 95% CI = -4.618 to -0.252, p = 0.029, Hedges' g = 0.552) at immediate post-intervention. However, these effects were not sustained at 3 months post-intervention. No significant between-group differences were detected in muscle mass, cardiac-related functional status, health-related quality of life or psychological outcomes. The effect sizes for these outcomes at the two timepoints ranged from 0.155 to 0.750. The resistance-based exercise intervention was feasible and acceptable for CAD patients with sarcopenia, improving their short-term physical performance and muscle strength. A full-scale trial with longer-term follow-up is warranted to evaluate its effects on functional, muscle and cardiac-related clinical outcomes. ClincialTrials.gov (NCT05497687).

Test-retest reliability and concurrent validity of the unilateral seated shot-put test in patients with subacromial pain syndrome

ABSTRACT The aim of this cross-sectional study was to assess the test-retest reliability and concurrent validity of the Unilateral Seated Shot-Put Test (USSPT) in patients with subacromial pain syndrome (SAPS). Twenty three patients were included in the study. The participants were assessed using the USSPT for functional power; Visual analog scale (VAS) for pain at activity; Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and Shoulder Pain and Disability Index (SPADI) for disability, hand-held dynamometer for shoulder flexion and shoulder abduction muscle strength, and grip strength. Test-retest reliability of the USSPT was found excellent with an intraclass correlation coefficient (ICC2,1) score of 0.976, a standard error of measurement (SEM) of 12.47, and a minimum detectable change (MDC95) score of 34.54. There was high to excellent correlations between the USSPT and the SPADI (r = -0.756, p = <0.001), shoulder flexion muscle strength (r = 0.834, p = <0.001), and shoulder abduction muscle strength (r = 0.711, p = <0.001). SPADI score and shoulder flexion muscle strength were the most important factors influencing USSPT performance, accounting for 73.3% of the variance. The USSPT is a reliable and valid test for assessing upper extremity functional power.

The relationship between physical inactivity and sexual dysfunction among patients receiving hemodialysis.

Chronic Kidney Disease (CKD), in its final stage, requires renal replacement therapy, such as hemodialysis (HD) to maintain vital functions; nevertheless, it imposes lifestyle changes. For example, physical activity (PA) levels are lower than the World Health Organization recommendations, consequently affecting physical performance. On the other hand, up to 80% of patients receiving HD have reported sexual dysfunction. Therefore, this study aimed to associate physical inactivity with sexual dysfunction in patients receiving HD. an analytical cross-sectional study was conducted on 116 ambulatory HD patients. Self-reported questionnaires for sexual dysfunction, IIEF and IFSF, and physical performance tests, such as theIPAQ-SF for physical activity levels, the six-minute walk test, the handgrip strength test, and the sit-to-stand test, were used to assess patients. A multivariate regression model was performed to identify predictors of sexual dysfunction. 86.4% ofwomen and 84.2% of themen reported sexual dysfunction. An association between physical inactivity and sexual dysfunction was found (OR = 5.6, 95% CI 1.77-17.71, p = 0.003). Logistic regression revealed that PA (OR = 0.997, p = 0.004), diabetes (OR = 7.558, p = 0.028), handgrip strength (OR = 1.819, p = < 0.001), and sit-to-stand repetitions (OR = 0.779, p = 0.004) were predictors of sexual dysfunction. Our study found that physical inactivity increases the risk of sexual dysfunction in CKD patients receiving HD, where the presence of diabetes is the main risk factor, and physical performance has a protective effect. Therapeutic exercise programs should be implemented as part of an integral approach in HD units, to improve patients' physical and sexual function.

The impact of ovarian aging on muscle strength and life quality in various reproductive aging stages

Objective Ovarian aging significantly impacts women’s overall aging, affecting various systems including the musculoskeletal system. This study investigates the correlation between ovarian function and handgrip strength (HGS) across reproductive aging stages and their relation to health-related quality of life (HRQoL). Method A cross-sectional study was conducted with female participants spanning all stages of ovarian function. HGS was measured using a dynamometer, and ovarian function was assessed via hormone levels (estradiol [E2], follicle stimulating hormone [FSH], luteinizing hormone [LH], prolactin [PRL], progesterone [P4] and testosterone). HRQoL was evaluated using the Sarcopenia-specific Quality of Life questionnaire (SarQoL). Data analysis involved analysis of variance and Pearson’s correlations, adjusted for confounding factors. Results The prevalence of possible sarcopenia increased from 3.8% in premenopausal women to 10.3% in postmenopausal women. After adjusting for covariates (age, SarQoL, FSH, LH, FSH/LH ratio, PRL, E2, P4 and testosterone), the negative correlation between HGS and the Kupperman Menopausal Index (KMI) was no longer significant. However, the positive correlation between HGS and the SarQoL remained significant in both the overall population and the postmenopausal group. The negative correlation between HGS and FSH was no longer significant after controlling for age, KMI, LH and E2; however, it persisted after controlling for the SarQoL, FSH/LH ratio, PRL, P4 and testosterone. Conclusion HGS is positively correlated with the SarQoL and negatively correlated with age in the overall population. No significant association was found between HGS and testosterone, E2, LH or FSH/LH ratio. Further research is needed to clarify the relationship between HGS and the KMI or FSH.

Comparison of the effectiveness of kinesiologic taping and high intensity laser therapy in lateral elbow tendinopathy: A randomized controlled trial.

Comparison of the effectiveness of kinesiologic taping and high intensity laser therapy in lateral elbow tendinopathy: A randomized controlled trial.

High rate of failure after magnesium bioabsorbable compression screw fixation for scaphoid fractures

PurposeThis retrospective study aimed to evaluate the clinical and radiological outcomes of magnesium (Mg) bioabsorbable compression screws in the management of scaphoid fractures and nonunion. Despite theoretical benefits, such as osteoinductive properties and gradual degradation facilitating bone remodeling of these novel implants, clinical evidence on their efficacy remains limited.Materials and methodsA retrospective analysis was conducted on 20 patients who underwent scaphoid fracture or nonunion surgery with Mg screws at our hospital between 2015 and 2024. Patients with a minimum of 12 months of radiological follow-up were included. Functional assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) and Mayo Wrist Score, while radiographic outcomes focused on union, screw integrity, and cystic changes. Statistical analysis compared grip strength and wrist range of motion to the contralateral side.ResultsThe mean clinical follow-up period was 78.3 months (SD ± 22.0; range 14–108), and the mean radiological follow-up was 59.1 months (SD ± 30.5; range 12–99). Functional assessments showed a mean Q-DASH score of 11.5 (SD ± 16.9; range 0–68.2) and a Mayo Wrist Score of 75.7 (SD ± 13.3; range 45–95), indicating moderate functional recovery. The non-union rate was 40%, with complications including screw breakage in 25% of patients and cystic lesion formation around screws in most cases. No infections were reported. Wrist range of motion and grip strength were both significantly reduced on the injured side compared to the intact side.ConclusionsMg screws demonstrate potential benefits for bioabsorbable fixation, but our findings indicate a high rate of complications, including non-union and screw instability, in scaphoid fractures. The study suggests that Mg screws may not provide adequate stability for complex fractures in small bones like the scaphoid.Level of evidenceLevel IV, retrospective cohort study.

Early Evaluation of the Short Physical Performance Battery in Hospitalized Patients with Chronic Kidney Disease Predicts Long-Term Hospitalization

The relationship between hospitalization duration and physical function in patients with chronic kidney disease (CKD) has not been thoroughly investigated. This study aimed to determine whether assessment of physical function one week after hospitalization can predict the length of stay in patients with CKD. A retrospective study was conducted on hospitalized patients with CKD who underwent rehabilitation between March 2019 and March 2020. Physical function was evaluated using the Short Physical Performance Battery (SPPB), grip strength, and Barthel Index and analyzed alongside clinical data. The mean age of the participants was 73.4 ± 11.9 years, with 92% having stage G4 or G5 CKD. Multivariate analysis revealed that the SPPB (β = −0.33, p &lt; 0.01) at one week after admission was significantly associated with the length of hospital stay (R2 = 0.11, p &lt; 0.02). Notably, in the subgroup of patients who were transferred to other facilities, the SPPB alone showed a strong association with the length of stay (β = −0.66, p &lt; 0.03, R2 = 0.23, p &lt; 0.05). The SPPB score in the early stages of hospitalization for patients with CKD was found to be a significant predictor of the length of stay, even after considering the eGFR and the Charlson Comorbidity Index. These findings may contribute to optimizing inpatient management and rehabilitation strategies for patients with CKD.

Predictive analysis of dominant hand grip strength among young children aged 6–15 years using machine learning techniques: a decision tree and regression analysis

Predictive analysis of dominant hand grip strength among young children aged 6–15 years using machine learning techniques: a decision tree and regression analysis

Monopedal robot branch-to-branch leaping and landing inspired by squirrel balance control.

Locomotors traversing arboreal environments must often leap across large gaps to land on small-diameter supports. Balancing these dynamic landings is challenging because of high incident momentum, restricted foothold options, and reduced capacity to produce reaction torques on narrow supports. We hypothesized that leg length control to enhance branch reaction control authority would markedly expand the range of successful landing conditions, drawing on the same powerful leg actuation required for leaping. Exploring this balance strategy, the monopedal robot Salto-1P demonstrates branch-to-branch leaps, including some upright balanced landings, despite negligible grasping torque. We also compared this landing strategy with the landings of squirrels, which similarly lack the grip strength found in other arboreal species. We demonstrate that greater radial force control reduces the inertial body torque and/or grasping torque at the support required to balance a given landing. Adding simple radial force balance control strategies to conventional balance controllers greatly expands potential landing conditions, increasing the range of initial angular momentum that can be balanced by 230 and 470% across ranges of landing angles for low-order models of the robot and squirrel, respectively.

Hamate autograft for proximal pole scaphoid fracture: A systematic review.

Hamate autograft for proximal pole scaphoid fracture: A systematic review.

Low creatinine to cystatin C ratio is associated with lower muscle volumes and poorer gait speeds in the longitudinal Integrated Women's Health Program cohort.

Little is known about the longitudinal associations between creatinine-cystatin C ratios (CCR) with muscle volume and function during the menopausal transition. We investigated the longitudinal relationship of baseline CCR, with muscle volumes measured by magnetic resonance imaging (MRI), and objectively measured muscle strength and physical performance after 6.6-year follow-up. Participants from the Integrated Women's Health Programme (IWHP) cohort (n = 891, baseline mean age 56.2 ± 6.0) who attended both baseline and follow-up visits underwent objectively measured muscle strength and physical performance assessments and MRI. Creatinine to cystatin C ratio was calculated as (creatinine [mg/dL] / cystatin C [mg/L]) and low CCR were those in the lowest tertile (CCR < 8.16). Multivariable regression analyses were used to determine the associations of baseline CCR with muscle volumes and function 6.6 years later. Baseline low CCR was associated with lower MRI-measured muscle volumes and poorer physical function 6.6 years later. Compared to high CCR group, mean fat-free thigh muscle volume of the low CCR group was 0.350 L lower (95% CI, 0.183-0.518) after adjustment for covariates. Similarly, the low CCR group was associated with 0.029 m/s slower (95% CI, 0.006-0.053) slower mean usual gait and 0.049 m/s slower (95% CI, 0.020-0.078) mean narrow gait speeds. CCR was not associated with handgrip strength and repeated chair stands and one-leg stand tests. Low CCR at baseline was associated with lower fat-free muscle volumes and poorer gait speeds 6.6 years later. The potential of CCR as a predictive biomarker for adverse events related to sarcopenia in midlife women merits further investigation.

Physical Fitness, Interlimb Asymmetry, and Injury Reports in Judo Athletes With Vision Impairments: A Cross-Sectional Study.

Investigating parameters related to physical capacities, muscular imbalance between the limbs, and injury reports in judo athletes with vision impairments (VI) is something extremely relevant for competitive performance, especially considering the absence of vision, which can be a determining factor in these aspects. For this, this study aimed to explore the interlimb asymmetry and bilateral strength index in upper and lower limbs in judo athletes with VI and describe the injury reports and the association with the muscular imbalance. A cross-sectional study. Eighteen judo athletes with VI participated in this cross-sectional study. Athletes performed the following physical tests: handgrip strength, countermovement jump, and medicine ball throw. All tests were performed unilaterally and bilaterally to calculate the interlimb asymmetry and the bilateral strength index. After this, an injury questionnaire was applied, considering injuries that occurred in the previous 6months. Student t tests and chi-square tests were used to compare groups and test the associations between injury reports, adopting the level of 5%. The results demonstrated that performance was higher for male compared with female athletes (P < .05) and asymmetry was influenced by sex (higher for male; P < .05) and the origin of the impairment (higher for acquired; P < .05). Furthermore, the bilateral strength deficit was more present in injured groups (mainly in medicine ball throw and countermovement jump). Finally, the most common mechanism of injury was direct contact with another athlete. Muscle imbalances were identified in male and female VI judo athletes and seem to be related to injury reports.

Changes in Adrenal Function and Insufficiency Symptoms After Cessation of Prednisolone

The widespread use of glucocorticoid (GC) therapy may result in GC-induced adrenal insufficiency (GIAI), but the prevalence and clinical implications remain uncertain. To ascertain the prevalence and symptoms of GIAI. Cross-sectional multicenter study at 3 Danish hospitals. Baseline data were collected March 2021 to March 2024 from an ongoing randomized clinical trial. Participants were patients with polymyalgia rheumatica and/or giant cell arteritis who were investigated a median (IQR) of 39 (25-62) days after planned cessation of prednisolone treatment. Prednisolone treatment a median (IQR) of 13 (10-20) months in duration. Primary outcome GIAI was defined as a stimulated plasma cortisol level less than 420 nmol/L in response to a short 250 μg corticotropin test (SST). Secondary outcomes were adrenal insufficiency symptoms assessed by the Addison disease-specific quality of life questionnaire (AddiQoL-30), body composition, and muscle function. Of 267 patients included (145 female [55%]; median [IQR] age 73 [68-78] years), 5 (1.9%; 95% CI, 0.8%-4.3%) had GIAI, whereas 75 (34%; 95% CI, 28%-41%) had symptoms compatible with adrenal insufficiency defined by an AddiQoL-30 score 85 or lower (symptomatic group). The symptomatic group had lower basal cortisol levels compared with the asymptomatic group (263 nmol/L; 95% CI, 242-283 nmol/L vs 309 nmol/L; 95% CI, 295-324 nmol/L; P < .001). Factors associated with a low AddiQoL-30 score included female sex (prevalence ratio [PR], 1.68; 95% CI, 1.13-2.51), increased body fat percentage (PR, 2.33; 95% CI, 1.21-4.50), reduced handgrip strength (PR, 2.71; 95% CI, 1.44-5.10) and low Short Physical Performance Battery score (PR, 2.78; 95% CI, 1.42-5.42). This cross-sectional study of 267 patients with polymyalgia rheumatica or giant cell arteritis found a GIAI prevalence of 1.9% after cessation of prednisolone. This is much lower than previously reported and speaks against routine screening, which should be restricted to patients with overt symptoms. The high prevalence of symptoms of adrenal insufficiency in association with lower basal cortisol levels substantiate the clinical challenges of steroid withdrawal and merit future research.

Cystatin-c / total cholesterol ratio as a predictor of probable sarcopenia in geriatric population from 12 European countries

BackgroundA low handgrip strength (HGS) is associated with several diseases in older adults. However, predictive biomarkers of future low HGS are poorly known. We investigated the prognostic efficacy of the ratio of plasma cystatin-c and total cholesterol (CT ratio) levels for predicting future low HGS in Europe.MethodsThe data was collected from the Survey of Health, Ageing, and Retirement in Europe (SHARE) between 2015 and 2021-22. The study participants were geriatric adults aged 50 or above (n = 17,698) from 12 European countries. The baseline data in 2015 included the measurements of CT ratio from participants with normal HGS. The participants who developed low HGS in subsequent years were included. We also investigated the quality of life, difficulties performing daily activities, and several comorbidities in the study population.ResultsIn a multivariate-adjusted model, male gender, advancing age, poor quality of life, difficulties performing daily activities, and the presence of depression, high blood pressure, diabetes mellitus, Alzheimer’s disease, and osteoarthritis were associated with a higher risk of developing low HGS. CT ratio exhibited significant prognostic accuracy for low HGS among men and women aged 60–79, irrespective of the quality of life, degree of depression, difficulties performing daily activities, and the presence of comorbidities, including depression, high blood pressure, diabetes mellitus, Alzheimer’s disease, and osteoarthritis.ConclusionCollectively, the CT ratio exhibits adequate prognostic accuracy for low HGS, which is not significantly affected by comorbidities and functional limitations. Our findings have clinical and policy implications in timely identifying older adults at risk of developing low HGS.