Relationship Between Handgrip Strength and Nonalcoholic Fatty Liver Disease: Nationwide Surveys

Background: The association of handgrip strength with nonalcoholic fatty liver disease (NAFLD) has not been studied yet. This study investigated the relationship between handgrip strength and NAFLD in South Korean adults. Methods: Referring to the Korea National Health and Nutrition Examination Survey 2014 and 2015 database, South Korean adults (n=8001, women: 55.5%) aged 19-80 years having complete data were considered for this study. Relative handgrip strength (RHGS) [average handgrip strength of both hands divided by body mass index (BMI)], hepatic steatosis index (HSI), BMI, and components of metabolic syndrome were measured. Demographics, treatment of concurrent illnesses, and health-related behaviors were assessed by using standardized questionnaires. NAFLD was defined by the HSI >36.0, alcohol consumption <20 grams/day, and negative biomarkers for chronic hepatitis B and C. Results: The prevalence of NAFLD was 30.3%0.7%. Complex sample logistic regression analysis revealed that individuals with lower RHGS [per 1 standard deviation (SD) decrease] manifested higher odds of suffering from NAFLD (adjusted odds ratio: 1.47, 95% confidence interval: 1.35-1.60). Furthermore, lower RHGS was associated with higher odds for NAFLD throughout the strata of sex, age group, education, BMI category, metabolic syndrome, treatment history of illnesses, smoking status, alcohol consumption, or physical activity. The odds for NAFLD increased in the range of 1.40-1.63 with 1 SD decrease in RHGS according to the strata. Conclusions: This study of South Korean adults suggests that lower handgrip strength is associated with NAFLD regardless of sociodemographic characteristics, weight status, metabolic syndrome, concurrent illnesses, and lifestyle.