In a cross-sectional study of 149 adult patients with prediabetes, relative handgrip strength demonstrated excellent discriminatory ability in identifying low handgrip strength-defined probable sarcopenia, with a corrected area under the curve of 0.867 and specificity of 96.4%.
Researchers evaluated adult patients aged 30 to 60 years with prediabetes recruited from a tertiary care center between February 2024 and June 2025. Probable sarcopenia was defined using Asian Working Group for Sarcopenia 2019 criteria cutoff values based on handgrip strength (HGS) thresholds, while relative handgrip strength (RHGS) was calculated by dividing HGS by body mass index (BMI). Receiver operating characteristic analysis assessed the ability of RHGS to identify low HGS-defined sarcopenia.
Probable sarcopenia was identified in 8% of the patients. The mean HGS was 28.7 kg in patients without sarcopenia vs 21.1 kg in those with sarcopenia. Mean relative handgrip strength was 1.17 in patients without sarcopenia vs 0.92 in those with sarcopenia, with a reported Cohen’s d of 1.25.
ROC curve analysis demonstrated that RHGS had excellent discriminatory ability, with a corrected area under the curve of 0.867. An optimal cutoff of 0.835 yielded a sensitivity of 66.7% and specificity of 96.4%.
In age-stratified data, male patients aged 50 to 60 years had a prevalence of probable sarcopenia of 33.3%, while female patients in the same age group had a prevalence of 16.7%. The mean HGS declined across increasing age groups.
Lower RHGS was also associated with adverse metabolic parameters. Vitamin D levels were significantly lower in the patients with probable sarcopenia. Among the patients with vitamin D levels greater than 30 ng/mL, 3% had probable sarcopenia compared with 18.4% in those with vitamin D levels of 20 to 30 ng/mL and 18.2% in those with levels less than 20 ng/mL.
Lower absolute HGS remained significantly associated with low HGS-defined probable sarcopenia after adjustment for age, sex, BMI, and HbA1c. In a separate adjusted model, RHGS also remained significantly associated with the outcome. Each 0.1-unit increase in RHGS was associated with a lower likelihood of HGS-defined probable sarcopenia after adjustment for age, sex, and HbA1c.
HGS measurements demonstrated consistent values across repeated trials, with high reliability reflected by a Cronbach’s alpha of 0.993 and intraclass correlation coefficients indicating excellent test-retest reliability. The cross-sectional nature of the study precluded assessment of causal or temporal relationships. Because the study was conducted at a single tertiary care center, the findings may have limited generalizability. Probable sarcopenia was defined using handgrip strength without direct assessment of muscle mass. Wide confidence intervals for some variables were noted, likely reflecting limited sample size and model instability.
“RHGS demonstrated strong discriminatory performance in identifying low HGS-defined probable sarcopenia and may serve as a practical screening tool in prediabetic populations,” wrote study authors Ganisetti Divya of Medicine, MD, and Kavita Chaudhry, MD, of the Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital in New Delhi.
The researchers reported no conflicts of interest.
Source: Cureus
