Multivariable reference centiles for maximum grip strength in childhood to young adults

OBJECTIVES: Maximum grip strength (mGS) is a useful predictor of health-related outcomes in children and adults. The aim of the study was to generate sex- and age-adjusted reference centiles for mGS for children, adolescents and young adults, while adjusting for body height and body mass index (BMI). METHODS: A retrospective analysis of longitudinal data from children and young adults participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study from 2004 to 2022 was conducted. A new algorithm combining multiple linear regression and the LMS method was used to generate sex-, age-, height- and BMI-adjusted reference centiles. RESULTS: 3325 measurements of mGS from 465 females and 511 males were eligible (median repeated measurements per individual: 3, range 1–8). Mean age at measurement was 12.6 ± 3.9 years in females and 12.4 ± 4.7 years in males. mGS correlated significantly with body height and BMI (r = 0.303–0.432; p < 0.001). Additional reference centiles for annualized change of mGS z-scores were generated for ages 8–20 years. CONCLUSIONS: The study proposes evaluating mGS in children, adolescents and young adults with reference centiles adjusted for sex, age, height and BMI, and presents, for the first time, reference centiles to assess change of mGS in repeated measurements. The method may be applicable to other biological variables that depend on more than sex and age.

Ibrahim Duran, Kim Ramona Wloka, Kyriakos Martakis, Karoline Spiess, Ute Alexy, Eckhard Schoenau