The combined effect of handgrip strength and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly: A cohort study.

• Low handgrip strength was associated with an increased risk of stroke. • Metabolically healthy overweight/obesity and metabolic abnormal phenotype increased the risk of stroke compared to metabolically healthy non-overweight/obesity. • The combination of abnormal obesity phenotype and low handgrip strength could further increase stroke risk more than single factor. • Weight control and muscle strength enhancement may be effective strategy to lower the risk of stroke. The aim of this study was to investigate the combined effect of handgrip strength (HGS) and obesity phenotype on the risk of stroke in Chinese middle-aged and elderly people. The data was used from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults who participated in surveys between 2011 and 2018 were included in the study. They were divided into 4 different types of obesity phenotypes based on obesity and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically abnormal non-overweight/obesity (MANO), and metabolically abnormal overweight/obesity (MAO). The HGS level was divided into low and high groups according to the median values. Cox proportional risk regression model was used to analyze the joint effect of HGS and obesity phenotype on the risk of stroke among participants. A total of 7904 participants aged 58.89±9.08 years were included in this study. After adjusting for potential confounders, high HGS&MHO (HR=1.86, 95 % CI=1.12–3.09), high HGS&MANO (HR=2.01, 95 %CI=1.42–2.86), high HGS&MAO (HR=2.01, 95 % CI=1.37–2.93), low HGS&MHNO (HR=1.57, 95 % CI=1.00–2.46), low HGS&MHO (HR=2.09, 95 % CI=1.29–3.38), low HGS&MANO (HR=2.02, 95 % CI=1.35–3.03), and low HGS&MAO (HR=2.48, 95 % CI=1.72–3.58) group had significantly higher risks of stroke than the high HGS&MHNO group. The coexistence of metabolically unhealthy and low HGS can synergistically increase the risk of stroke in Chinese middle-aged and elderly people. [ABSTRACT FROM AUTHOR]