Postgraduate research

Novel risk factors for type 2 diabetes and other adverse cardiometabolic outcomes – handgrip strength and other markers of physical fitness

Qualification: PhD

Department: Population Health Sciences

Application deadline: 31 May 2023

Start date: 25 September 2023


Supervisor: Dr Setor Kunutsor -

Project Description:

Cardiovascular disease is the leading cause of mortality associated with type 2 diabetes (T2D). Older age, obesity and lifestyle factors such as physical inactivity, smoking, excessive alcohol consumption and unhealthy diet are major risk factors for T2D. Although these established risk factors explain a large proportion of T2D risk, identification of individuals at high risk still remains a difficult undertaking, as a substantial amount of residual risk remains to be ascertained. There is still an urgent need to identify novel and simple markers that could be used to identify people at high risk of developing T2D.

Physical fitness is one of the strongest predictors of future health status and has components such as cardiorespiratory fitness, muscular strength, muscular power, balance, coordination, and flexibility. These markers including handgrip strength (a proxy measure of muscular strength) are emerging as strong risk indicators for adverse health outcomes. Though associations between individual markers of physical fitness and risk of T2D and other cardiometabolic outcomes have been demonstrated, available studies of such markers have been too small or insufficiently detailed to reliably characterise the nature of any associations and their relevance for predicting disease risk. Furthermore, the long-term relevance of these markers to disease risk is uncertain, given that employing baseline measurements of these markers could underestimate the true strength of any aetiological associations. 
Using the UK Biobank and other data sources, the specific objectives of the proposed project include:

1. Quantification of independent and combined associations of baseline levels of markers of physical fitness such as handgrip strength with the risk of type 2 diabetes and other adverse cardiometabolic conditions

2. Assessing the long-term relevance of these markers to risk of these outcomes using repeat measures of these markers

3. Assessment of whether measurement of such markers may help better identify people at increased risk of these conditions than traditional risk factors and can be integrated into clinical care using methods such as Harrell’s C-index, likelihood ratio test, R2, Akaike, Bayesian information criterion, net-reclassification improvement, integrated-discrimination-improvement, and decision curve analysis

Measures of physical fitness such as handgrip strength can be simple and inexpensive to assess and may not require skilled expertise and resources. If demonstrated to be useful in identifying people at increased of T2D and other cardiometabolic outcomes, they could easily be incorporated into routine screening programmes and clinical practice.


Kunutsor SK, Voutilainen A, Laukkanen JA. Handgrip strength improves prediction of type 2 diabetes: a prospective cohort study. Ann Med. 2020 Dec;52(8):471-478
Kunutsor SK, Isiozor NM, Khan H, Laukkanen JA. Handgrip strength-A risk indicator for type 2 diabetes: Systematic review and meta-analysis of observational cohort studies. Diabetes Metab Res Rev. 2021 Feb;37(2):e3365




This 3 year PhD Studentship provides

  • UK tuition fee waiver
  • Annual stipend at UKRI rates. (currently £17,668 for 2022/23. Stipend for 2023/4 to be confirmed shortly)

*International candidates should note that they will be required to cover the difference between the UK (Home) and International tuition fees each year (this will be in the region of £17,000 per annum and will be confirmed at the point of offer).

*Please note that this project is competition funded

Entry requirements

Entry requirements

Applicants are required to hold a UK Bachelor's Degree 2:1 (or overseas equivalent) or better in a relevant subject.

The University of Leicester English language requirements apply.

Informal enquiries

Informal enquiries

Project / Funding Enquiries:

How to apply

How to apply

To apply, please use the Apply button at the bottom of the page and select September 2023 from the dropdown menu.

With your application, please include: 

  • CV.
  • Personal statement explaining your interest in the project, your experience and why we should consider you.
  • Degree certificates and transcripts of study already completed and if possible transcript to date of study currently being undertaken.
  • Evidence of English language proficiency if applicable
  • In the reference section please enter the contact details of your two academic referees in the boxes provided or upload letters of reference if already available.
  • In the funding section please specify that you wish to be considered for the PHS Kunutsor Studentship.
  • In the research proposal section please provide the name of the project supervisors and the project title (a proposal is not required).



Open to UK and International*applicants

*International applicants please refer to funding information

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