The debate article highlights the importance of identifying sarcopenia, and the impact it has on reducing ‘physical performance’.1 It is also worth identifying that skeletal muscle is a ‘metabolic organ’, and that many of the associated adverse health outcomes may be potentiated by an endocrine mechanism. In order to screen for this, we propose the use of hand grip strength as a clinically relevant screening tool in general practice.
There is growing evidence that low hand grip strength is associated with an increased risk of developing diabetes.2,3 One study from the UK Biobank demonstrated that high-risk ‘South Asian’ populations have on average a 5–6 kg lower grip strength than ‘white European’ counterparts. When the relative prevalence of diabetes was taken into account, low grip strength in the ‘South Asian’ population was associated with an attributable risk of 3.9 (male) and 4.2 cases (female) per 100, as opposed to 2.0 (male) and 0.6 (female) in ‘white Europeans’.4
These studies support an interesting theory that there may be ethnicity-specific grip strength cut-offs, and one reason why there is no clear consensus on screening recommendations. Despite these drawbacks, it is clear that low hand grip strength is inversely proportional to disease-specific and all-cause mortality.5 Specific dietary and exercise interventions to improve muscle strength may reduce this risk significantly and help in the management of long-term conditions (LTCs).
We propose that enough evidence has accumulated over the last decade to support the use of hand grip strength as a clinically relevant screening tool in primary care. It allows for objective measurement of grip strength in a number of seconds; we hope that hand grip dynamometers find their common place in general practice in the near future.
- © British Journal of General Practice 2020
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