IS GREATER muscle strength is associated with a lower risk of developing Type 2 diabetes (T2D), regardless of an individual’s genetic predisposition? A recent prospective study explored the interplay between muscle strength and genetic risk, to determine their combined effect on the likelihood of developing T2D. A key finding revealed that individuals with high muscle strength and high genetic risk still had a reduced 8-year absolute risk of developing T2D than those with low or medium genetic risk but low muscle strength.
The study analysed data from 141,848 White British participants aged 40–69 years, without T2D at baseline. Muscle strength was measured using grip strength relative to fat-free mass, while genetic risk was determined via a polygenic risk score based on 138 single-nucleotide polymorphisms linked to T2D. Participants were categorised into tertiles of low, medium, and high muscle strength and genetic risk. Incident cases of T2D were identified over a median follow-up of 7.4 years using linked health records.
Results showed that individuals in the highest tertile of muscle strength had a 44% lower risk of developing T2D (hazard ratio [HR] 0.56; 95% CI: 0.52–0.60), and those in the medium group had a 27% reduction (HR 0.73; 95% CI: 0.68–0.78) compared to those in the lowest tertile, independent of genetic risk. Conversely, those with the highest genetic were associated with the greatest incident risk of T2D (HR 2.39; 95% CI: 2.17–2.63) compared to those with medium (HR 1.52; 95% CI: 1.40–1.66), and low genetic risk. Importantly, the association between higher muscle strength and reduced T2D risk was observed across all genetic risk categories but was weaker among those at highest genetic risk. Evidence of interaction between muscle strength and genetic risk was found on both additive (p=0.010) and multiplicative (p=0.046) scales.
In clinical practice, these findings highlight the potential value of targeting muscle strength as a modifiable factor to help mitigate T2D risk, especially among those with high genetic susceptibility. While the observational nature of the study limits causal inference and findings may not generalise beyond White British populations, the results support the need for further research.
Reference
Wang M et al. Prospective associations between muscle strength and genetic susceptibility to type 2 diabetes with incident type 2 diabetes: a UK Biobank study. BMC Med. 2025;23(1):93
