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Systematic review Handgrip strength thresholds associated with metabolic syndrome risk in children and adolescents: a systematic review and meta-analysis
Hye Ah Lee1orcid , Seunghee Jun2,3orcid , Hyesook Park2,3orcid
Epidemiol Health 2024;e2024047
DOI: https://doi.org/10.4178/epih.e2024047 [Accepted]
Published online: April 24, 2024
1Ewha Womans University Medical Center, Seoul , Korea
2Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
3Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
Corresponding author:  Hye Ah Lee,
Email: khyeah@naver.com
Received: 7 February 2024   • Revised: 27 March 2024   • Accepted: 7 April 2024
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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.
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 v2 (QUADAS-2) was used to evaluate quality, and a meta-analysis was performed using the diagmeta R package to suggest the optimal thresholds.
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.
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.

Epidemiol Health : Epidemiology and Health