Higher muscle strength associated with lower T2D risk | Multidisciplinary

Higher muscle strength is associated with lower relative risk of developing type 2 diabetes (T2D), irrespective of genetic susceptibility to T2D, while such association is weaker in the high genetic risk group, researchers from the University of Hong Kong (HKU) have found.

The study, which included 141,848 white British individuals from the UK Biobank (average age, 56.6 years; female, 54.8 percent), explored prospective associations between muscle strength and genetic susceptibility to T2D with respect to T2D risk. Analysis found that high muscle strength was associated with a 44 percent lower risk of T2D (hazard ratio [HR], 0.56; 95 percent confidence interval [CI], 0.52–0.60) compared with low muscle strength, after adjustment for genetic risk of T2D. The estimated 8-year absolute risk of T2D was lower for high genetic risk—high muscle strength (2.47 percent) compared with low or medium genetic risk combined with low muscle strength (2.90 and 4.00 percent, respectively). [BMC Medicine 2025;23:93]

The inverse association between muscle strength and incident T2D was weaker in individuals with high genetic susceptibility to T2D. Of note, the relative risk of T2D for muscle strength was, in general, greater in individuals at low genetic risk of T2D than in those at higher genetic risk, with p values for interaction between muscle strength and genetic susceptibility to T2D indicative of potential interaction (p_additive=0.010; p_{multiplicative}=0.046). Although the underlying mechanisms and causal evidence of the interaction remain uncertain, the authors postulated that the high genetic risk of T2D, which contributes to an overall high risk of developing the condition, may have led to the less pronounced associations of high muscle strength with T2D risk for these individuals.

Hand-grip strength was used as an indicator of overall muscle strength. Due to the potential impact of body size on grip strength, relative grip strength was derived as a quotient of absolute grip strength and body fat–free mass. Age- and sex-specific cut-off points for relative grip strength were then used to categorize participants into three groups based on the tertiles.

“This study highlights the significance of biobank studies in examining the interaction between exposures and genetics in influencing the risk of T2D. Further research utilizing ethnicity-specific biobank data is needed to determine if these findings are applicable to other populations, such as East Asians,” said Professor Ryan Au Yeung, from the School of Public Health, LKS Faculty of Medicine, HKU, a co-author of the study.

“Individuals in middle-to-late life are at increased risk of T2D. This study has demonstrated the potential roles of high muscle strength in reducing the future risk of developing T2D not only in all, but also in individuals with high genetic predisposition to T2D,” added Professor Youngwon Kim from the School of Public Health, LKS Faculty of Medicine, HKU, the corresponding author of the study. “Our study supports current public health guidelines, which recommend adults to engage in muscle-strengthening activities for at least 2 days per week for disease prevention.”