Effect of Inflammation on Handgrip Strength in the Non-Critically Ill Is Independent from Age, Gender and Body Composition

European Journal of Clinical Nutrition. 2014 Feb; 68(2):155-8. doi: 10.1038/ejcn.2013.261. Epub 2013 Dec 11.
Norman, K., Stobäus, N., Kulka, K., & Schulzke, J.


Background/Objectives: We investigated whether C-reactive protein (CRP) as indicator of acute inflammation is associated with maximal isometric handgrip strength in non-critically ill patients.

Subjects/Methods: Handgrip strength was measured with Jamar dynamometer in 620 hospitalized patients (56.4±15.9 years old, 52.3% men). CRP was measured with immunoturbidimetric assay. Fat free mass (FFM) was assessed by bioelectrical impedance analysis. A general linear model regression analysis corrected for confounding variables such as age, sex, FFM, body mass index, comorbidity count and diagnosis category (malignant/benign disease) was performed to test the association between elevated levels of CRP and handgrip strength.

Results: CRP was an independent predictor of grip strength (CRP: β-coefficient: -0.169, P=0.018) even after adjustment for relevant confounders. All groups with inflammation showed significant reduction in handgrip strength, corresponding to a loss of ∼1.6 kg in mild inflammation, 3.2 kg in moderate inflammation and 2.9 kg in severe inflammation compared with patients without inflammation.

Discussion: Our data demonstrate the independent association between inflammation and handgrip strength in non-critically ill patients. If not corrected, reduced strength may have implications for the patients' functional status and prognosis. Increasing physical activity and resistance training during convalescence are recommended.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism