Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study

Leong DP 1 , Teo KK 1 , Rangarajan S 1 , Kutty VR 2 , Lanas F 3 , Hui C 4 Show all authors , Quanyong X 5 , Zhenzhen Q 6 , Jinhua T 7 , Noorhassim I 8 , AlHabib KF 9 , Moss SJ 10 , Rosengren A 11 , Akalin AA 12 , Rahman O 13 , Chifamba J 14 , Orlandini A 15 , Kumar R 16 , Yeates K 17 , Gupta R 18 , Yusufali A 19 , Dans A 20 , Avezum Á 21 , Lopez-Jaramillo P 22 , Poirier P 23 , Heidari H 24 , Zatonska K 25 , Iqbal R 26 , Khatib R 27 , Yusuf S 1

Affiliations 

  • 1 The Population Health Research Institute McMaster University and Hamilton Health Sciences Hamilton ON Canada
  • 2 Health Action by People, 'Chemmanam', Navarangam Lane Medical College Post Office Trivandrum India
  • 3 Universidad de La Frontera Chile
  • 4 Medical Research & Biometrics Center National Center for Cardiovascular Diseases, FuWai Hospital Beijing China
  • 5 Jiangsu Provincial Center for Disease Control &12 Prevention Nanjing City China
  • 6 Jiangxinzhou community health service center Nanjing City China
  • 7 Xiaohang Hospital Nanjing City China
  • 8 Universiti Kebangsaan Malaysia Medical Center(UKMMC) Kuala Lumpur Malaysia
  • 9 Department of Cardiac Sciences, King Fahad Cardiac Center College of Medicine, King Saud University Riyadh Saudi Arabia
  • 10 North-West University Physical activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences Potchefstroom South Africa
  • 11 Sahlgrenska University Hospital/Östra Hospital Göteborg Sweden
  • 12 Department of Family Medicine and Department of Medical Education Yeditepe University Medical Faculty Atasehir, Istanbul Turkey
  • 13 Independent University Bangladesh Bangladesh
  • 14 University of Zimbabwe College of Health Sciences Department of Physiology Harare
  • 15 Estudios Clínicos Latino America Rosario Argentina
  • 16 PGIMER School of Public Health Chandigarh India
  • 17 Department of Medicine Queen's University Kingston ON Canada
  • 18 Fortis Escorts Hospital Jaipur India
  • 19 Hatta Hospital, Dubai Health Authority Dubai
  • 20 College of Medicine University of the Philippines - Manila Malate Philippines
  • 21 Dante Pazzanese Institute of Cardiology São Paulo Brazil
  • 22 Fundacion Oftalmologica de Santander (FOSCAL) Universidad de Santander (UDES) Bucaramanga Colombia
  • 23 Institut universitaire de cardiologie et de pneumologie de Québec Québec Canada
  • 24 Cardiac Rehabilitation Research Center Isfahan University of Medical Sciences Isfahan Iran
  • 25 Department of Social Medicine Medical University of Wroclaw Poland
  • 26 Departments of Community Health Sciences and Medicine Aga Khan University Pakistan
  • 27 Institute of Community and Public Health Birzeit University Ramallah Palestine
J Cachexia Sarcopenia Muscle, 2016 12;7(5):535-546.
PMID: 27104109

Abstract

BACKGROUND: The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions.

METHODS: HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study.

RESULTS: HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th-75th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported.

CONCLUSIONS: Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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