Does hand grip strength correlate with clinical disease activity in CD?

Hand grip may be associated with clinical disease activity in patients with Crohn’s disease (CD), but hand grip measurements alone may not be the best predictor of disease activity or related disability, suggests a study presented at Crohn’s and Colitis Congress 2024.

“[We sought] to determine whether grip strength, as a predictor of sarcopenia and frailty, is associated with clinical symptoms, endoscopic disease activity, and disease-related disability in patients with inflammatory bowel disease (IBD),” said the researchers.

IBD may result in malnutrition and body composition alteration such as the development of sarcopenia, a known component of frailty, which is a driver of poor health outcomes and a significant independent predictor of mortality in IBD patients, they said.

“[We found an association between] low hand grip strength [and] clinical disease activity in patients with CD but not ulcerative colitis (UC). [However,] our study does not suggest hand grip strength to be associated with IBD-related disability or endoscopic disease activity in either patients with UC or CD,” the researchers said.

The team conducted a prospective cohort study in a single tertiary care centre (n=74; mean age 47.06 years, 51.4 percent men). Most participants (62 percent) had CD while the rest had UC. Mean disease duration was 15.7 years. [CCC 2024, abstract 047]

Participants were asked to complete two paper surveys addressing clinical symptoms and IBD Disability Index. Grip strength measurements were obtained using a Jamar dynamometer and adjusted for age and sex by Z-score calculation.

Overall, the mean hand grip Z-score was lower in patients not in clinical remission compared with those who were in clinical remission (–0.160 vs 0.480; p=0.025). On subgroup analysis based on diag­nosis, statistical significance was maintained in the CD (–0.230 vs 0.610; p=0.044) but not the UC group (0.020 vs 0.340; p=0.544).

Mean hand grip Z-score was not associated with IBD Disability Index (–0.070 vs 0.250; p=0.669) or endoscopic disease activity (0.210 vs 0.070; p=0.513 [UC] and –0.108 vs 0.274; p=0.638 [CD]).

Larger studies warranted

While the findings imply a correlation between hand grip and clinical disease activity in CD patients, the study does not support hand grip measurements as predictive of disease activity or related disability, the researchers noted.

The findings also appear to deviate from evidence suggesting that handgrip strength index may be an effective parameter for predicting muscular health in patients with CD. [J Crohns Colitis 2016;10:1395-1400]

Larger studies with a wider representation of disease severity (including hospitalized IBD patients), are warranted to ascertain the results. Given the lack of validated diagnostic criteria for sarcopenia and frailty in the IBD population, additional diagnostic modalities may also be necessary, they said.