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Park, Lee, Han, Kim, Choi, and Kim: The Association between Muscle Strength and Hyperuricemia in the Healthy Middle-aged Adult in Yangpyeong Province
Clinical Article

Korean J Sports Med 2018;36(1):7-14.

Published online: 10 December 2018

DOI: https://doi.org/10.5763/kjsm.2018.36.1.7

The Association between Muscle Strength and Hyperuricemia in the Healthy Middle-aged Adult in Yangpyeong Province

Dooyong Park1, On Lee1, Sang Woong Han2, Mi Kyung Kim3, Bo Youl Choi3, Yeon Soo Kim1, 4

1Department of Physical Education, College of Education, Seoul National University, Seoul, Korea

2Divison of Nephrology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea

3Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea

4Institute of Sport Science, Seoul National University, Seoul, Korea

Correspondence: Yeon Soo Kim Department of Physical Education, College of Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea Tel: +82-2-880-7794, Fax: +82-2-880-7794, E-mail: kys0101@snu.ac.kr

This research was supported by a fund (2007-E71002-00, 2008-E71004-00, 2009-E71006-00, 2010-E71003-00, 2011-E71002-00, 2012-E71007-00, 2013-E71008-00, 2014-E71006-00) by Research of Korea Centers for Disease Control and Prevention.

* Current affiliation: GC HealthCare, Seongnam, Korea

Received 29 September 2017       Revised 19 December 2017       Accepted 20 December 2017

Copyright © 2018 The Korean Society of Sports Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study aimed to examine the prevalence of hyperuricemia in association with relative grip strength and leg strength in Korean Elderly.

Methods

We studied cross-sectional analysis with 1,894 rural adults (40−88 years old), who were surveyed for 7 years from 2007 to 2014. Grip strength was measured by using Takei grip strength dynamometer. Leg strength was measured by using Takei leg strength dynamometer. Hyperuricemia was defined by examining serum uric acid concentration (male ≥7 mg/dL, female ≥6 mg/dL). Logistic regression was conducted to evaluate the association of grip strength and leg strength with hyperuricemia (p＜0.05).

Results

Subjects who reported high level of relative grip strength had a significantly lower odds ratio (OR) of hyperuricemia than subjects who reported low level of relative grip strength (OR, 0.37; 95% confidence interval [CI], 0.16−0.84). When it comes to sex, subjects both high relative muscle strength are significantly lower multivariate-adjusted OR of hyperuricemia than subjects both low relative muscle strength in male (OR, 0.52; 95% CI, 0.29−0.95) and female (OR, 0.47; 95% CI, 0.26−0.95). Additionally, senior group (age ≥65 years), who have low relative grip strength and high relative leg strength, was only significantly associated with the prevalence of hyperuricemia (OR, 0.43; 95% CI, 0.19−0.98).

Conclusion

The relationship between hyperuricemia and relative grip strength may be mediated through decreased estimated glomerular filtration ratio. Therefore, muscle strength is important factor in prevention of renal vascular dysfunction which is a risk factor of hyperuricemia, and resistance exercise is needed to improve muscle strength.

Keywords: Exercise, Glomerular filtration rate, Hand strength, Hyperuricemia, Muscle strength

References

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Table 1.
Baseline characteristics of study participants
Characteristics of risk factor Total (n=1,894) Male (n=711)
 p-value Female (n=1,183)
 p-value
Non-HU (n=594) HU (n=117) Non-HU (n=1,084) HU (n=99)
Age (yr) 60.31±10.39 62.43±10.12 61.78±9.84 0.525 58.74±10.28 63.00±10.87 ＜0.001
BMI (kg/m2) 24.39±3.17 23.69±2.95 24.94±2.96 ＜0.001 24.54±3.14 26.32±3.89 ＜0.001
Lean body mass (kg) 41.63±7.64 48.29±6.59 50.08±6.90 0.008 37.42±4.45 37.75±5.05 0.487
High alcohol intake (%) 49.52 66.67 73.50 0.071 31.83 44.44 0.080
Meat intake (%) 33.47 61.95 52.14 0.059 65.87 52.53 0.010
History of hypertension (%) 17.32 16.16 14.53 0.659 17.90 21.21 0.413
eGFR (mL/min per 1.73 m2) 68.67±9.70 72.43±9.57 65.66±9.93 ＜0.001 67.78±8.71 59.28±10.70 ＜0.001
C-reactive protein (mg/dL) 1.74±5.58 1.96±4.26 2.44±3.81 0.258 1.33±2.27 4.11±20.21 ＜0.001
Fasting glucose level (mg/dL) 99.85±18.07 103.03±21.47 100.84±16.20 0.296 97.63±16.02 103.81±15.30 ＜0.001
Serum total protein (g/dL) 7.30±0.39 7.27±0.38 7.40±0.40 0.002 7.30±0.39 7.43±0.35 0.002
Exercise participation (% ≥3 wk/day) 18.85 15.15 13.68 0.682 21.31 20.20 0.796
Grip strength/BMI (%)       0.423     ＜0.001
 Low 33.32 32.66 36.75   31.73 50.51  
 Middle 33.32 33.00 35.04   33.30 33.33  
 High 33.37 34.34 28.21   34.96 16.16  
Leg strength/BMI (%)       0.140     0.008
 Low 33.32 33.33 33.33   32.10 46.46  
 Middle 33.32 31.99 40.17   33.49 31.31  
 High 33.37 34.68 26.50   34.41 22.22  
Grip × leg relative strength (% %)     –     –
 Low grip/low leg strength 35.11 33.16 36.75   34.13 55.56  
 Low grip/high leg strength 14.84 16.16 16.24   14.30 11.11  
 High grip/low leg strength 14.89 15.82 17.95   14.58 9.09  
 High grip/high leg strength 35.16 34.85 29.06   36.99 24.24  

Values are presented as mean±standard deviation.

HU: hyperuricemia, BMI: body mass index, eGFR: estimated glomerular filtration ratio.

Table 2.
Association relative grip strength with hyperuricemia in healthy adult
Relative grip strength Age and sex-adjusted OR (95% CI) (n=1,894) Multivariable-adjusted OR (95% CI) (n=1,894)
Model 1 Model 2 Model 3 Model 4
Low Reference Reference Reference Reference Reference
Middle 0.78 (0.56−1.10) 0.72 (0.50−1.03) 0.73 (0.51−1.05) 0.74 (0.51−1.07) 0.47 (0.19−1.18)
High 0.51 (0.34−0.76) 0.52 (0.33−0.80) 0.52 (0.34−0.82) 0.48 (0.31−0.76) 0.37 (0.16−0.84)
p-trend 0.001 0.003 0.004 0.002 0.017

Multivariable Model 1 adjusted leg strength, age, sex, history of hypertension, CRP, exercise status, fasting glucose, serum total protein, lean body mass; Model 2, model 1 plus adjusted for meat intake, drinking status; Model 3, model 2 plus adjusted for status of CKD; Model 4, model 3 plus adjusted for interaction of CKD and grip. OR: odds ratio, CI: confidence interval, CRP: C-reactive protein, CKD: chronic kidney disease.

Table 3.
Association relative grip strength and leg strength with hyperuricemia by sex
Grip×leg relative strength Total (n=1,894)
 Male (n=711)
 Female (n=1,183)
Age and sex-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI) Age-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI) Age-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI)
Low grip/low Reference Reference Reference Reference Reference Reference
 leg strength            
Low grip/high 0.68 0.64 0.82 0.78 0.56 0.48
 leg strength (0.43−1.07) (0.39−1.03) (0.45−1.52) (0.41−1.51) (0.28−1.11) (0.23−1.01)
High grip/low 0.68 0.65 0.93 0.93 0.41 0.37
 leg strength (0.43−1.05) (0.40−1.06) (0.51−1.69) (0.48−1.78) (0.19−0.85) (0.17−0.82)
High grip/high 0.58 0.49 0.64 0.52 0.54 0.47
 leg strength (0.39−0.86) (0.32−0.74) (0.36−1.11) (0.29−0.95) (0.31−0.95) (0.26−0.95)

Multivariable model adjusted leg strength, age, sex, meat intake, drinking status, history of hypertension, CRP, eGFR, exercise status, fasting glucose, serum total protein, lean body mass. OR: odds ratio, CI: confidence interval, CRP: C-reactive protein, eGFR: estimated glomerular filtration.

Table 4.
Association relative grip strength and leg strength with hyperuricemia by age
Grip×leg relative strength Total (n=1,894)
 Age ＜65 yr (n=1,140)
 Age ≥65 yr (n=754)
Age and sex-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI) Age and sex-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI) Age and sex-adjusted OR (95% CI) Multivariable-adjusted OR (95% CI)
Low grip/low Reference Reference Reference Reference Reference Reference
 leg strength            
Low grip/high 0.68 0.64 0.80 0.74 0.47 0.43
 leg strength (0.43−1.07) (0.39−1.03) (0.44−1.45) (0.39−1.38) (0.21−1.03) (0.19−0.98)
High grip/low 0.68 0.65 0.72 0.66 0.58 0.58
 leg strength (0.43−1.05) (0.40−1.06) (0.38−1.34) (0.33−1.30) (0.30−1.12) (0.28−1.18)
High grip/high 0.58 0.49 0.44 0.37 1.03 0.84
 leg strength (0.39−0.86) (0.32−0.74) (0.26−0.74) (0.21−0.64) (0.58−1.85) (0.45−1.60)

Multivariable model adjusted leg strength, age, sex, meat intake, drinking status, history of hypertension, CRP, eGFR, exercise status, fasting glucose, serum total protein, lean body mass. OR: odds ratio, CI: confidence interval, CRP: C-reactive protein, eGFR: estimated glomerular filtration.

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