Poor toe flexor strength, but not handgrip strength, is associated with the prevalence of diabetes mellitus in middle-aged males

Abstract

Abstract. Previous studies suggested that reduced muscular strength was one of the potential predictor of prevalence of diabetes mellitus. The purpose of this study was to investigate the association between toe flexor strength (TFS) and handgrip strength (HGS) and the prevalence of diabetes mellitus. Cross-sectional analysis was conducted using data from 1,390 Japanese males (35-59 years). TFS and HGS were measured and medical examinations undertaken. The prevalence of diabetes mellitus was defined as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% (48 mmol/mol), and/or current use of anti-diabetes mellitus drugs. A total of 114 participants had diabetes mellitus. TFS in participants with diabetes mellitus was significantly lower than that in persons not suffering from diabetes mellitus but HGS was not. Odds ratio (OR) and 95% confidence interval (CI) per 1-standard deviation-increase in muscular strength measurements for the prevalence of diabetes mellitus were obtained using a multiple logistic regression model. Prevalence of diabetes mellitus was inversely related to TFS (OR 0.769, 95% CI 0.614-0.963), TFS/body mass (BM) (0.696, 0.545-0.889) and TFS/body mass index (BMI) (0.690, 0.539-0.882) after adjustment of covariates. Such associations were not observed in HGS (OR 0.976, 95% CI 0.773-1.232), HGS/BM (0.868, 0.666-1.133) or HGS/BMI (0.826, 0.642-1.062). These results suggested that poor TFS was associated with an increased prevalence of diabetes mellitus independent of visceral fat accumulation, but HGS was not, in middle-aged males. TFS may be a better marker for the prevalence of diabetes mellitus than HGS. SKELETAL MUSCLE plays an important role in the regulation of substrate utilization in the whole body owing to its considerable capacity for the metabolism of glucose and lipid via insulin-and contraction-induced signals [1]. A reduced mass of skeletal muscle and reduced fitness are related to the prevalence of diabetes mellitus, impaired glucose tolerance, and insulin resistance [2][3][4]. In addition, resistance exercise training can reduce the risk of type-2 diabetes mellitus significantly independent of aerobic exercise training [5,6]. Therefore, the strength and mass of the muscle may have a role Submitted Dec. 6, 2017; Accepted Feb. 25, 2018 as EJ17-0517 Released online in J-STAGE as advance publication Mar. 28, 2018 Correspondence to: Masataka Suwa, PhD., Health Support Center WELPO, Toyota Motor Corporation, 1-1, Ipponmatsu, Iwakuracho, Toyota, Aichi, 444-2225, Japan. E-mail: masataka_suwa@mail.toyota.co.jp in the amelioration and/or prevention of diabetes mellitus.Many epidemiologic studies have estimated handgrip strength (HGS) as an indicator of muscular strength which is associated with mortality, heart failure, cancer, falling, and activities of daily living [7,8]. Several studies have demonstrated that poor HGS is associated with the prevalence of diabetes mellitus and increased level of fasting blood glucose (FBG) [9][10][11][12][13][14], but other studies have not indi...

Evaluation of the development process and effects of a foot care program with educational tools for nurses and care workers as in-home service providers

“…This study was not limited to the item pools of other studies on foot care [10,11]. It included the effects of prolonged sedentary or toe movements [12][13][14][15] and differentiation between soft tissue and lymphatic massages based on their physical implications [16,17]. Educational tools were created using five steps: full planning, draft creation, evaluation initiation (before implementation), process evaluation (immediately after implementation), and impact evaluation (after intervention).…”

The correlation between toe flexor strength and performance-based measures of physical fitness in the elderly

“…Toe flexion is a combination of the action of plantar intrinsic and extrinsic muscles 1) . Toe flexor strength (TFS) is related to physical activity level 2,3) , locomotive performance 4) , fall [5][6][7] , diabetes mellitus 8) , and cognitive function 9) ; thus, evaluation of TFS may be useful for screening for health and aging-related problems.…”

“…We previously showed the characteristics of TFS such as age-related decline and relationship of diabetes mellitus as well as physical fitness level in males 3,8,10) . TFS is correlated with other physical fitness performance measurements including upper and lower limb strength, body flexibility, and dynamic balance in elderly males 3) .…”