The Association of Handgrip Strength in the Second Trimester with Gestational Hyperglycemia

PURPOSE: While handgrip strength (HGS) is linked to insulin resistance and type 2 diabetes in adults, its association with gestational diabetes mellitus (GDM) is unclear. We aimed to assess associations of second-trimester HGS with GDM and glucose metabolism, and to determine its predictive value for GDM. STUDY DESIGN: This prospective cohort study enrolled 1904 pregnant women from Hefei, China. HGS was assessed using a dynamometer at recruitment between 16 and 23 weeks of gestation. Logistic regression models were used to assess the relationship between HGS quartiles and GDM risk, based on standard glucose metabolism outcomes. RESULTS: GDM prevalence was 19.3%. Higher HGS was associated with a lower risk of GDM (P for trend <0.001). Versus the lowest quartile, the highest HGS quartile showed reductions in FPG (-4.8%), 1-h PG (-12.5%), 2-h PG (-11.3%), fasting insulin (-20.2%), and HOMA-IR (-24.8%). The RCS curves demonstrated a significant and linear relationship between HGS and GDM (P value < 0.001). An ROC analysis indicated that adding HGS (cut-off: 24.1 kg) improved the predictive performance for GDM. CONCLUSIONS: Lower second-trimester HGS independently predicts GDM risk and hyperglycemia, supporting its use as an inexpensive initial screening tool in primary care, particularly in resource-limited settings.