Handgrip strength is not independently associated with steatosis in people with MASLD

Reduced handgrip strength (HGS) is considered a surrogate marker of whole-body muscle strength and has been associated with sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD). This cross-sectional study investigated the relationship between HGS, steatosis and fibrosis in a primary care and endocrinology cohort. Steatosis was defined as a controlled attenuation parameter (CAP™) > 248 dB/m, and fibrosis as vibration-controlled transient elastography (VCTE™) > 8 kPa. HGS was measured using a hydraulic hand dynamometer and expressed as absolute HGS, BMI-adjusted HGS (bHGS), and height-adjusted HGS (hHGS). Among 422 participants (median age 61 years; median BMI 28.1 kg/m2), 264 (62.5%) had MASLD and 57 (13.5%) had fibrosis. Participants with MASLD had significantly lower bHGS than those without MASLD, whereas absolute HGS and hHGS did not differ. In the MASLD cohort, bHGS showed a weak inverse correlation with CAP. However, after adjustment for age, sex, BMI, smoking, alcohol consumption, and type 2 diabetes mellitus, no independent associations were observed between any of the HGS measures and steatosis. These findings suggest that reduced bHGS, but not hHGS or absolute HGS, is associated with greater steatosis severity but is not an independent predictor of MASLD or liver fibrosis.