Genome-wide polygenic risk score for muscle strength predicts lower risk for common diseases and longer life span among the Finnish population: a prospective population based cohort study of the 342 443 FinnGen participants

Purpose To use a genome-wide polygenic risk score for hand grip strength (PRS HGS) to investigate whether the muscle strength genotype predicts the most common age related noncommunicable diseases, survival from acute adverse health events, and all cause mortality. Methods This study consisted of 342 443 Finnish biobank participants from FinnGen Data Freeze 10 (53% women) aged 40 to 108 with combined genotype and health registry data. Associations were explored with a linear or Cox proportional hazards regression models. Results A higher PRS HGS predicted a lower body mass index (BMI) (β = −0.112 kg/m2, standard error (SE) = 0.017, P = 1.69 × 10−11) in women but not in men (β = 0.004 kg/m2, P = 0.768, sex by PRS HGS interaction: P = 2.12 × 10−07). In all participants, a higher PRS HGS was associated with a lower risk for obesity diagnosis (hazard ratio 0.94, 95% confidence interval 0.93 to 0.95), type 2 diabetes (0.95, 0.94 to 0.96), ischemic heart diseases (0.97, 0.96 to 0.97), hypertension (0.97, 0.96 to 0.97), stroke (0.97, 0.96 to 0.98), asthma (0.94, 0.93 to 0.95), chronic obstructive pulmonary disease (0.94, 0.92 to 0.95), polyarthrosis (0.90, 0.88 to 0.92), knee arthrosis (0.98, 0.97 to 0.99), rheumatoid arthritis (0.95, 0.94 to 0.97), osteoporosis (0.95, 0.93 to 0.97), falls (0.98, 0.98 to 0.99), depression (0.95, 0.94 to 0.96), and vascular dementia (0.93, 0.89 to 0.96). In women only, a higher PRS predicted a lower hazard for any dementia (0.94, 0.92 to 0.96) and Alzheimer’s disease (0.96, 0.93 to 0.98). Participants with a higher PRS HGS had a decreased risk of cardiovascular (0.96, 0.95 to 0.98) and all cause mortality (0.97, 0.96 to 0.98). However, the predictive value of the PRS HGS for mortality was not pronounced after adverse acute health events compared to the non-diseased period. Conclusions The genotype that supports higher muscle strength protects against many future health adversities. Further research is needed to investigate whether or how a favourable lifestyle modifies this intrinsic capacity to resist diseases, and if the impacts of lifestyle behaviour on health differ due to polygenic risk. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the Academy of Finland (grants 341750 and 346509 to ES, 336823 to JK), the Juho Vainio Foundation (ES), the Päivikki and Sakari Sohlberg Foundation (ES), and the JYU.Well - School of Wellbeing of the University of Jyväskylä (K.K.). The funders of the study had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the article for publication. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Patients and control subjects in FinnGen and FINRISK provided informed consent for biobank research, based on the Finnish Biobank Act. Alternatively, separate research cohorts, collected prior the Finnish Biobank Act came into effect (in September 2013) and start of FinnGen (August 2017), were collected based on study-specific consents and later transferred to the Finnish biobanks after approval by Fimea (Finnish Medicines Agency), the National Supervisory Authority for Welfare and Health. Recruitment protocols followed the biobank protocols approved by Fimea. The Coordinating Ethics Committee of the Hospital District of Helsinki and Uusimaa (HUS) statement number for the FinnGen study is Nr HUS/990/2017. The FinnGen study is approved by Finnish Institute for Health and Welfare, Digital and population data service agency, the Social Insurance Institution, Findata, Statistics Finland and Finnish Registry for Kidney Diseases permission/extract from the meeting minutes on 4th July 2019. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Researchers can apply to use the FinnGen resource and access the data used. The Finnish biobank data can be accessed through the Fingenious® services (https://site.fingenious.fi/en/) managed by FINBB. Finnish Health register data can be applied from Findata (https://findata.fi/en/data/).