Table 1. Characteristics by diabetes status in 2516 men and 6664 women from the Guangzhou Biobank Cohort Study
|
Normoglycaemia
|
IFG only
|
IGT only
|
IFG+IGT
|
T2DM
|
Known T2DM
|
P value
|
Men
|
|
Number
|
1271
|
224
|
363
|
150
|
209
|
299
|
|
Fasting glucose, mmol/l, mean (SD)
|
4.93 (0.42)
|
5.93 (0.28)
|
5.08 (0.44)
|
6.01 (0.30)
|
7.09 (2.31)
|
7.70 (3.15)
|
<0.001
|
Post-load glucose, mmol/l, mean (SD)
|
6.03 (1.26)
|
6.47 (1.37)
|
8.90 (0.84)
|
9.17 (0.90)
|
14.42 (4.32)
|
9.25 (4.33)
|
<0.001
|
Age, years, mean (SD)
|
67.38 (6.68)
|
67.28 (6.71)
|
69.38 (6.49)
|
68.31 (6.68)
|
69.18 (5.66)
|
68.88 (6.37)
|
<0.001
|
Education, %
|
|
|
|
|
|
|
|
Primary or below
|
27.87
|
27.68
|
25.34
|
24.00
|
30.62
|
25.42
|
0.11
|
Middle school
|
57.17
|
52.68
|
57.30
|
58.67
|
52.15
|
51.51
|
College or above
|
14.96
|
19.64
|
17.36
|
17.33
|
17.22
|
23.08
|
Smoking status, %
|
|
|
|
|
|
|
|
Never
|
41.67
|
43.30
|
47.66
|
48.67
|
47.12
|
46.15
|
<0.001
|
Former
|
24.86
|
29.02
|
29.20
|
30.00
|
30.29
|
31.77
|
Current
|
33.46
|
27.68
|
23.14
|
21.33
|
22.60
|
22.07
|
Alcohol use, %
|
|
|
|
|
|
|
|
Never
|
29.43
|
34.38
|
28.93
|
32.67
|
35.89
|
37.12
|
0.003
|
Former
|
0.63
|
2.68
|
0.00
|
1.33
|
0.48
|
0.67
|
Current
|
69.94
|
62.95
|
71.07
|
66.00
|
63.64
|
62.21
|
Physical activity, %
|
|
|
|
|
|
|
|
Inactive
|
2.28
|
1.34
|
1.38
|
0.67
|
2.87
|
1.34
|
0.24
|
Minimally active
|
27.14
|
25.00
|
30.30
|
24.67
|
34.45
|
28.76
|
Active
|
70.57
|
73.66
|
68.32
|
74.67
|
62.68
|
69.90
|
Poor health, %
|
60.82
|
58.48
|
56.98
|
59.31
|
61.54
|
64.43
|
0.49
|
Body fat, %, mean (SD)
|
21.04 (6.00)
|
23.35 (5.26)
|
22.47 (6.19)
|
24.47 (5.86)
|
24.47 (5.57)
|
23.01 (5.69)
|
<0.001
|
Waist circumference, cm, mean (SD)
|
82.30 (8.60)
|
86.35 (8.95)
|
85.18 (9.13)
|
88.07 (8.82)
|
88.17 (9.09)
|
87.20 (8.66)
|
<0.001
|
BMI, kg/m2, mean (SD)
|
22.86 (3.08)
|
23.97 (3.32)
|
23.83 (3.46)
|
25.03 (4.34)
|
24.66 (3.20)
|
24.44 (3.47)
|
<0.001
|
Women
|
|
Number
|
3395
|
487
|
993
|
391
|
558
|
840
|
|
Fasting glucose, mmol/l, mean (SD)
|
4.94 (0.36)
|
5.90 (0.27)
|
5.10 (0.36)
|
6.00 (0.32)
|
6.90 (2.14)
|
7.69 (2.85)
|
<0.001
|
Post-load glucose, mmol/l, mean (SD)
|
6.14 (1.03)
|
6.67 (1.18)
|
8.91 (0.83)
|
9.19 (0.94)
|
14.28 (4.11)
|
10.98 (5.06)
|
<0.001
|
Age, years, mean (SD)
|
63.70 (6.84)
|
63.81 (7.10)
|
65.80 (6.51)
|
66.17 (6.74)
|
66.25 (6.61)
|
66.64 (6.41)
|
<0.001
|
Education, %
|
|
|
|
|
|
|
|
Primary or below
|
38.47
|
43.33
|
46.83
|
47.83
|
53.23
|
51.90
|
<0.001
|
Middle school
|
54.46
|
52.77
|
46.02
|
44.76
|
40.32
|
41.07
|
College or above
|
7.07
|
3.90
|
7.15
|
7.42
|
6.45
|
7.02
|
Smoking status, %
|
|
|
|
|
|
|
|
Never
|
97.48
|
97.32
|
97.77
|
98.19
|
97.84
|
97.12
|
0.35
|
Former
|
0.98
|
1.44
|
0.81
|
1.29
|
0.90
|
1.92
|
Current
|
1.54
|
1.24
|
1.42
|
0.52
|
1.26
|
0.96
|
Alcohol use, %
|
|
|
|
|
|
|
|
Never
|
45.71
|
51.85
|
46.27
|
47.06
|
49.01
|
57.23
|
<0.001
|
Former
|
0.27
|
0.00
|
0.30
|
0.00
|
0.72
|
0.36
|
Current
|
54.03
|
48.15
|
53.43
|
52.94
|
50.27
|
42.41
|
Physical activity, %
|
|
|
|
|
|
|
|
Inactive
|
2.56
|
0.62
|
2.62
|
3.58
|
2.69
|
2.62
|
0.002
|
Minimally active
|
21.06
|
20.33
|
23.77
|
23.53
|
24.37
|
27.14
|
Active
|
76.38
|
79.06
|
73.62
|
72.89
|
72.94
|
70.24
|
Poor health, %
|
64.08
|
60.46
|
64.34
|
63.73
|
63.47
|
73.56
|
<0.001
|
Body fat, %, mean (SD)
|
31.54 (6.74)
|
34.46 (6.74)
|
33.14 (6.71)
|
36.09 (6.56)
|
36.26 (6.66)
|
33.47 (6.69)
|
<0.001
|
Waist circumference, cm, mean(SD)
|
79.69 (8.40)
|
82.99 (8.71)
|
82.17 (8.57)
|
84.95 (8.68)
|
85.67 (8.95)
|
83.90 (9.27)
|
<0.001
|
BMI, kg/m2, mean (SD)
|
23.30 (3.50)
|
24.47 (3.47)
|
24.19 (3.36)
|
25.19 (3.23)
|
25.53 (3.72)
|
24.48 (3.58)
|
<0.001
|
IFG only, impaired fasting glucose only, i.e., fasting level of 5.6-6.9 mmol/l and 2hPG <7.8 mmol/l; IGT only, impaired glucose tolerance only, i.e., 2hPG level of 7.8-11.09 mmol/l and fasting glucose <5.6 mmol/l; IFG+IGT, the presence of both impaired fasting glucose and impaired glucose tolerance; T2DM, type 2 diabetes mellitus, i.e., fasting glucose ≥7.0 mmol/l or 2hPG ≥11.1 mmol/l; Known T2DM, a history of self-reported physician-diagnosed diabetes or the use of glucose-lowering drugs regularly, Post-load glucose, 2h oral glucose tolerance test; BMI, body mass index; SD, standard deviation.
Table 2. Grip strength by different diabetes status in 2516 men and 6664 women
|
Normoglycaemia
|
IFG only
|
IGT only
|
IFG+IGT
|
T2DM
|
Known T2DM
|
P for trend†
|
Men
|
Number of subjects
|
1271
|
224
|
363
|
150
|
209
|
299
|
|
Relative grip strength max†
|
1.38 (1.34, 1.42)
|
1.37 (1.33, 1.40)
|
1.36 (1.32, 1.39)
|
1.35 (1.30, 1.39)
|
1.33 (1.29, 1.38)
|
1.32 (1.27, 1.37)
|
0.02
|
Relative grip strength mean†
|
1.30 (1.27, 1.34)
|
1.29 (1.26, 1.33)
|
1.28 (1.25, 1.31)
|
1.27 (1.24, 1.31)
|
1.26 (1.22, 1.30)
|
1.25 (1.21, 1.29)
|
0.01
|
Relative grip strength left†
|
1.30 (1.26, 1.33)
|
1.28 (1.25, 1.32)
|
1.27 (1.23, 1.31)
|
1.26 (1.22, 1.30)
|
1.25 (1.21, 1.29)
|
1.24 (1.19, 1.29)
|
0.01
|
Relative grip strength right†
|
1.31 (1.27, 1.35)
|
1.30 (1.27, 1.33)
|
1.29 (1.26, 1.33)
|
1.28 (1.25, 1.32)
|
1.27 (1.23, 1.31)
|
1.26 (1.22, 1.31)
|
0.01
|
Absolute grip strength, kg††
|
32.76 (31.88, 33.65)
|
32.52 (31.68, 33.36)
|
32.27 (31.43, 33.12)
|
32.03 (31.14, 32.92)
|
31.79 (30.80, 32.77)
|
31.54 (30.44, 32.64)
|
0.03
|
Women
|
Number of subjects
|
3395
|
487
|
993
|
391
|
558
|
840
|
|
Relative grip strength max†
|
0.91 (0.89, 0.92)
|
0.90 (0.89, 0.92)
|
0.90 (0.89, 0.91)
|
0.90 (0.88, 0.91)
|
0.89 (0.87, 0.91)
|
0.88 (0.86, 0.90)
|
0.03
|
Relative grip strength mean†
|
0.86 (0.84, 0.87)
|
0.85 (0.84, 0.87)
|
0.85 (0.84, 0.86)
|
0.85 (0.84, 0.86)
|
0.85 (0.83, 0.86)
|
0.84 (0.83, 0.86)
|
0.17
|
Relative grip strength left†
|
0.85 (0.84, 0.86)
|
0.85 (0.83, 0.86)
|
0.84 (0.83, 0.86)
|
0.84 (0.83, 0.85)
|
0.84 (0.82, 0.85)
|
0.83 (0.81, 0.85)
|
0.15
|
Relative grip strength right†
|
0.86 (0.85, 0.88)
|
0.86 (0.85, 0.87)
|
0.86 (0.85, 0.87)
|
0.86 (0.84, 0.87)
|
0.85 (0.84, 0.87)
|
0.85 (0.83, 0.87)
|
0.15
|
Absolute grip strength, kg††
|
20.82 (20.49, 21.14)
|
20.72 (20.43, 20.01)
|
20.62 (20.33, 20.91)
|
20.52 (20.20, 20.85)
|
20.42 (20.04, 20.81)
|
20.33 (19.87, 20.78)
|
0.07
|
Total
|
Number of subjects
|
4666
|
711
|
1356
|
541
|
767
|
1139
|
|
Relative grip strength max$
|
1.02 (1.01, 1.03)
|
1.01 (1.00, 1.02)
|
1.00 (1.00, 1.01)
|
1.00 (0.99, 1.01)
|
0.99 (0.98, 1.00)
|
0.99 (0.97, 1.00)
|
0.005
|
Relative grip strength mean$
|
0.96 (0.95, 0.97)
|
0.95 (0.95, 0.96)
|
0.95 (0.94, 0.96)
|
0.94 (0.94, 0.95)
|
0.94 (0.93, 0.95)
|
0.94 (0.92, 0.95)
|
0.03
|
Relative grip strength left$
|
0.95 (0.94, 0.96)
|
0.94 (0.94, 0.95)
|
0.94 (0.93, 0.94)
|
0.93 (0.92, 0.94)
|
0.93 (0.91, 0.94)
|
0.92 (0.91, 0.94)
|
0.02
|
Relative grip strength right$
|
0.97 (0.96, 0.98)
|
0.97 (0.96, 0.97)
|
0.96 (0.95, 0.97)
|
0.96 (0.95, 0.97)
|
0.95 (0.94, 0.96)
|
0.95 (0.93, 0.96)
|
0.02
|
Absolute grip strength, kg$$
|
23.79 (23.58, 24.06)
|
23.67 (23.50, 23.84)
|
23.54 (23.38, 23.71)
|
23.42 (23.21, 23.63)
|
23.30 (23.01, 23.58)
|
23.17 (22.81, 23.53)
|
0.008
|
Results were shown as mean (95% confidence interval), except for numbers.
†: Adjusted for age, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference.
††: Adjusted for age, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference and body mass index (BMI).
$: Adjusted for age, sex, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference.
$$: Adjusted for age, sex, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference and BMI.
IFG, impaired fasting glucose; IGT, impaired glucose tolerance; T2DM, type 2 diabetes; relative grip strength max, maximal of the average of the right or the left grip strength divided by BMI; Relative grip strength mean, the mean of the average of both the right and the left grip strength divided by BMI; Relative grip strength left, the average of the left grip strength divided by BMI; Relative grip strength right, the average of the right grip strength divided by BMI; Absolute grip strength, maximal of the average of the right or the left grip strength.
Table 3. Grip strength by fasting glucose (in quartiles and as continuous, mmol/l) in 1271 men and 3394 women with normoglycaemia
|
Quartile of fasting glucose in normoglycaemia, mmol/l
|
Adjusted β†
|
P for trend
|
|
1st
|
2nd
|
3rd
|
4th
|
Men
|
Number of subjects
|
314
|
310
|
319
|
328
|
-
|
-
|
Fasting glucose, mmol/l
|
4.39 (4.35, 4.42)
|
4.82 (4.81, 4.83)
|
5.07 (5.07, 5.08)
|
5.40 (5.38, 5.42)
|
-
|
-
|
Post-load glucose, mmol/l†
|
5.94 (5.76, 6.13)
|
6.14 (5.97, 6.30)
|
6.26 (6.10, 6.43)
|
6.42 (6.24, 6.60)
|
0.51 (0.33, 0.68)***
|
<0.001
|
Relative grip strength max†
|
1.43 (1.37, 1.49)
|
1.43 (1.37, 1.48)
|
1.43 (1.37, 1.48)
|
1.43 (1.37, 1.49)
|
-0.004 (-0.06, 0.05)
|
0.88
|
Relative grip strength mean†
|
1.35 (1.30, 1.41)
|
1.35 (1.30, 1.40)
|
1.35 (1.30, 1.39)
|
1.35 (1.30, 1.40)
|
-0.01 (-0.06, 0.04)
|
0.70
|
Relative grip strength left†
|
1.35 (1.29, 1.41)
|
1.34 (1.29, 1.40)
|
1.34 (1.28, 1.40)
|
1.34 (1.28, 1.40)
|
-0.01 (-0.07, 0.05)
|
0.67
|
Relative grip strength right†
|
1.36 (1.31, 1.41)
|
1.36 (1.31, 1.40)
|
1.36 (1.31, 1.40)
|
1.35 (1.31, 1.40)
|
-0.008 (-0.05, 0.04)
|
0.75
|
Absolute grip strength, kg††
|
33.27 (31.92, 34.61)
|
33.21 (32.03, 34.40)
|
33.18 (32.00, 34.36)
|
33.14 (31.85, 34.42)
|
-0.14 (-1.39, 1.12)
|
0.83
|
Women
|
Number of subjects
|
840
|
833
|
844
|
877
|
-
|
-
|
Fasting glucose, mmol/l
|
4.46 (4.45, 4.48)
|
4.82 (4.82, 4.82)
|
5.07 (5.07, 5.08)
|
5.37 (5.37, 5.38)
|
-
|
-
|
Post-load glucose, mmol/l†
|
5.89 (5.82, 5.97)
|
6.07 (6.01, 6.13)
|
6.19 (6.13, 6.25)
|
6.34 (6.26, 6.41)
|
0.47 (0.37, 0.57)***
|
<0.001
|
Relative grip strength max†
|
0.95 (0.93, 0.98)
|
0.94 (0.92, 0.96)
|
0.93 (0.91, 0.95)
|
0.92 (0.89, 0.94)
|
-0.04 (-0.08, -0.005)*
|
0.03
|
Relative grip strength mean†
|
0.90 (0.88, 0.92)
|
0.89 (0.87, 0.90)
|
0.87 (0.86, 0.89)
|
0.86 (0.84, 0.88)
|
-0.04 (-0.07, -0.02)**
|
0.002
|
Relative grip strength left†
|
0.90 (0.87, 0.92)
|
0.88 (0.86, 0.90)
|
0.87 (0.85, 0.89)
|
0.85 (0.83, 0.88)
|
-0.05 (-0.08, -0.02)**
|
0.003
|
Relative grip strength right†
|
0.91 (0.88, 0.93)
|
0.89 (0.87, 0.91)
|
0.88 (0.86, 0.90)
|
0.87 (0.85, 0.89)
|
-0.04 (-0.07, -0.006)*
|
0.02
|
Absolute grip strength, kg††
|
21.26 (20.70, 21.83)
|
20.89 (20.45, 21.33)
|
20.64 (20.19, 21.10)
|
20.34 (19.77, 20.90)
|
-0.98 (-1.74, -0.22)*
|
0.01
|
Total
|
Number of subjects
|
1154
|
1143
|
1163
|
1205
|
|
|
Fasting glucose, mmol/l
|
4.44 (4.43, 4.46)
|
4.82 (4.816, 4.82)
|
5.07 (5.07, 5.08)
|
5.38 (5.37, 5.39)
|
-
|
-
|
Post-load glucose, mmol/l$
|
5.88 (5.82, 5.93)
|
6.06 (6.03, 6.09)
|
6.18 (6.15, 6.22)
|
6.33 (6.28, 6.38)
|
0.48 (0.40, 0.57) ***
|
<0.001
|
Relative grip strength max$
|
1.06 (1.04, 1.08)
|
1.05 (1.04, 1.06)
|
1.04 (1.03, 1.06)
|
1.03 (1.02, 1.05)
|
-0.03 (-0.06, -0.00008)*
|
0.049
|
Relative grip strength mean$
|
1.01 (0.99, 1.02)
|
0.99 (0.98, 1.00)
|
0.98 (0.97, 0.99)
|
0.97 (0.96, 0.99)
|
-0.04 (-0.06, -0.01)**
|
0.006
|
Relative grip strength left$
|
1.00 (0.98, 1.01)
|
0.98 (0.97, 0.99)
|
0.97 (0.96, 0.98)
|
0.96 (0.94, 0.98)
|
-0.04 (-0.07, -0.01)**
|
0.008
|
Relative grip strength right$
|
1.01 (1.00, 1.03)
|
1.00 (0.99, 1.01)
|
1.00 (0.99, 1.01)
|
0.99 (0.97, 1.00)
|
-0.03 (-0.06, -0.003)*
|
0.03
|
Absolute grip strength, kg$$
|
24.23 (23.82, 24.63)
|
23.97 (23.72, 24.22)
|
23.80 (23.54, 24.06)
|
23.59 (23.21, 23.97)
|
-0.68 (-1.33, -0.02)*
|
0.04
|
Results were shown as mean (95% confidence interval), except for numbers.
Relative grip strength max, maximal of the average of the right or the left grip strength divided by body mass index (BMI); Relative grip strength mean, the mean of the average of both the right and the left grip strength divided by BMI; Relative grip strength left, the average of the left grip strength divided by BMI; Relative grip strength right, the average of the right grip strength divided by BMI; Absolute grip strength, maximal of the average of the right or the left grip strength.
P values for sex interaction with fasting glucose in terms of all measures of grip strength were from 0.13 to 0.92.
†: Adjusted for age, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference.
††: Adjusted for age, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference and BMI.
$: Adjusted for age, sex, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference.
$$: Adjusted for age, sex, education, smoking status, alcohol use, physical activity, body fat percentage and waist circumference and BMI.
*: P<0.05; **: P<0.01; ***: P<0.001.