Epidemiology and Health

Original article

Prospective association between handgrip strength in childhood and the metabolic syndrome score and insulin resistance indices in adolescence: an analysis based on the Ewha Birth and Growth Study: Seunghee Jun, Hyunjin Park, Hyelim Lee, Hye Ah Lee, Young Sun Hong, Hyesook Park; Epidemiol Health. 2025;e2025001. Published online January 2, 2025; DOI: https://doi.org/10.4178/epih.e2025001 [Accepted]

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Abstract Summary PDF: Abstract
OBJECTIVES
Low handgrip strength in children and adolescents might be associated with the risk of metabolic syndrome (MetS) and insulin resistance. This study prospectively evaluated the association between handgrip strength (HGS) in childhood and MetS in adolescence.
METHODS
Based on data from the Ewha Birth and Growth Study, this study analyzed handgrip strength at ages 7 to 9 and metabolic indices at ages 13 to 15. In total, 219 participants were analyzed. The risk of MetS was evaluated using the continuous MetS score (cMetS), and insulin resistance was assessed using fasting blood insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Relative handgrip strength in childhood was determined by dividing handgrip strength by body weight and categorized as sex-specific quartiles.
RESULTS
This study found an inverse association between relative handgrip strength levels in childhood and MetS and insulin resistance in adolescence. For each 1-group increase in relative handgrip strength quartiles, cMetS (Std. β=-0.64, p<0.01), HOMA-IR (Std. β=-0.21, p<0.01), and fasting blood insulin (Std. β=-0.21, p<0.01) all decreased on average. These associations remained significant even after adjusting for confounding factors.
CONCLUSIONS
Our study showed a prospective association between handgrip strength in childhood and the risk of MetS and insulin resistance in adolescence. It provides significant epidemiological evidence, emphasizing the importance of efforts to increase muscle strength from a young age to mitigate the risk of MetS and insulin resistance in adolescence.; Summary

Korean summary
본 연구는 소아기 악력 수준이 청소년기의 대사증후군 및 인슐린 저항성과 연관이 있음을 발견했음. 이러한 결과는 소아기 근력 향상이 향후 대사 위험을 완화하는데 중요함을 강조함.

Key Message
This study found that higher childhood relative handgrip strength was inversely associated with metabolic syndrome and insulin resistance in adolescence. The findings emphasize the importance of enhancing muscle strength early in life to mitigate metabolic risks.

Systematic Review

Handgrip strength thresholds associated with metabolic syndrome risk in children and adolescents: a systematic review and meta-analysis: Hye Ah Lee, Seunghee Jun, Hyesook Park; Epidemiol Health. 2024;46:e2024047. Published online April 24, 2024; DOI: https://doi.org/10.4178/epih.e2024047

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Certain studies have reported that handgrip strength (HGS) is associated with metabolic health risks in children and adolescents, and some studies have suggested HGS thresholds for identifying poor metabolic health. Therefore, we aimed to determine the HGS thresholds associated with metabolic syndrome (MetS) in children and adolescents through a systematic review.
METHODS
We searched 3 electronic databases from their inception until October 2023 to identify original papers that focused on children and adolescents and assessed their risks of MetS according to specific HGS values. Studies were selected for inclusion through a planned screening process based on specific criteria. The Quality Assessment Tool for Diagnostic Accuracy Studies version 2 (QUADAS-2) was used to evaluate quality, and a meta-analysis was performed using the diagmeta R package to suggest the optimal thresholds.
RESULTS
From the search, 8 studies were selected for this systematic review. For detecting MetS risk, the optimal threshold for HGS (defined as relative HGS by adjusting for body mass) was found to be 0.422, with a sensitivity of 76.7% (95% confidence interval [CI], 64.0 to 85.8) and a specificity of 62.9% (95% CI, 56.9 to 68.5). The stratification analysis by sex resulted in optimal thresholds of 0.416 for boys and 0.376 for girls. Additionally, when the data were stratified by age, the thresholds were 0.356 for children and 0.416 for adolescents.
CONCLUSIONS
Our results provide practical information for detecting high-risk groups and encouraging strength-related activities that may reduce the risk of MetS in children and adolescents.; Summary

Korean summary
- 본 연구는 체계적 고찰 및 메타 분석을 수행하여 아동 및 청소년의 대사 증후군(MetS) 위험을 감지하기 위한 최적의 악력 임계값을 제안했습니다. - 본 연구 결과는 아동 및 청소년의 대사 증후군(MetS) 위험을 줄이기 위해 근력 관련 활동이 필요한 고위험군을 식별하는 데 사용할 수 있으므로 1차 임상 및 공공 의료에 실용적인 정보를 제공합니다.

Key Message
- This study conducted a systematic review and meta-analysis to propose the optimal handgrip strength (HGS) threshold for detecting the risk of metabolic syndrome in children and adolescents. - The results provide practical information for primary clinical and public healthcare, as they can be used to identify high-risk groups in need of strength-related interventions to reduce the risk of metabolic syndrome in children and adolescents.

Special Article

Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis: Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park; Epidemiol Health. 2023;45:e2023092. Published online October 16, 2023; DOI: https://doi.org/10.4178/epih.e2023092

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545 Download
8 Web of Science
12 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.

METHODS

Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.

RESULTS

Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.

CONCLUSIONS

Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.

Summary

Korean summary
본 연구는 코호트 연구를 기반으로 하여 음주의 수준에 따른 암 위험 연관성에 대해 체계적 문헌고찰(139편)과 메타분석(106편)을 수행하였다. 연구 결과, 음주와 암 위험 사이에 용량-반응 관계가 나타났으며, 소량의 음주는 암 유형에 따라 차이가 있었으나, 식도암, 대장암, 전립선암(남성), 유방암(여성)에서 암 위험과의 연관성이 있음을 발견했다. 따라서, 암 위험 측면에서 음주에 안전한 수준이 없음을 시사하며, 음주와 관련된 잠재적 피해를 완화하기 위해서는 음주 지침 강화와 같은 공중보건개입이 필요하다.

Key Message
The aim of this study was to assess the relationship between different levels of alcohol consumption and the risk of various cancer types through a systematic review and meta-analysis, providing insights into the ongoing debate about alcohol consumption and cancer causality. The findings support a dose-response relationship between alcohol consumption levels and cancer risk and the light alcohol consumption was associated with risks of esophageal, colorectal, prostate (male), and breast (female) cancer. These results emphasize the absence of a safe threshold for alcohol consumption in terms of cancer risk.

Citations

Citations to this article as recorded by

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