PURPOSE:The purpose of this study was to examine the association of resting heart rate (RHR) and relative hand grip strength (RHGS) with diabetes among Korean adult over 65 years old.METHODS: Cross-sectional analyses were performed using the 2015-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Among 31,649, a total of 4,814 adults over 65 years old were included in this study. Participants were divided into tertile according to their RHR and RHGS. Statistical methods included frequency analysis, ANCOVA (Analysis of covariance) and logistic regression.RESULTS: Participants in the 3rd tertile of RHR (RHR over 73 bpm in men, 74 bpm in women) had 2.00 times [95% Confidence Interval (CI): 1.58-2.54] and 1.80 times (95% CI: 1.44-2.26) higher odds of having diabetes in men and women, respectively, compared with participants in the 1st tertile (RHR below 64 bpm in male, 65 bpm in female). Participants in the 1st tertile of RHGS (RHGS below 0.46 in men, 0.31 in women) had 2.51 times (95% CI: 1.76-3.58) and 1.86 times (95% CI: 1.48-2.35) higher odds of having diabetes in men and women, respectively, compared to participants with 3rd tertile (RHGS over 0.54 in men, 0.38 in women). When a joint association of RHR and RHGS with risks of diabetes were analyzed, participants with the highest RHR and the lowest RHGS had 4.23 times (95% CI: 2.74-6.54) and 2.90 times (95% CI: 1.98-4.23) higher odds of having diabetes compared to participants with the lowest RHR and the highest RHGS in men and women, respectively.CONCLUSIONS: The current study showed that higher RHR and lower RHGS were associated with increased risk of diabetes in Korean elderly population.