Prevalence, Clinical Profile, Iron Status, and Subject-Specific Traits for Excessive Erythrocytosis in Andean Adults Living Permanently at 3,825 Meters Above Sea Level
Prevalence, Clinical Profile, Iron Status, and Subject-Specific Traits for Excessive Erythrocytosis in Andean Adults Living Permanently at 3,825 Meters Above Sea Level
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DOI：
10.1378/chest.14-0298
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发表时间：
2014-11-01
期刊：
影响因子：
9.6
通讯作者：
Checkley, William
中科院分区：
文献类型：
--
作者：
De Ferrari, Aldo;Miranda, J. Jaime;Checkley, William
背景：过度红细胞增多症（EE）是生活在高海拔（海拔> 2,500 m）人群中的一种常见疾病。很少有大规模的基于人群的研究探讨了EE和多个受试者特异性特征之间的关联，包括血氧饱和度、铁状态指标和肺功能。我们从秘鲁的普诺招募了1,065名年龄≥ 35岁的高海拔居民作为性别分层和年龄分层样本（海拔3，825米），并进行了标准化问卷调查和体格检查，包括肺功能测定、脉搏血氧测定和多种临床标志物的血液样本。我们的主要目标是估计EE的患病率，表征EE的临床特征和铁状态指标的受试者，并描述与EE.RESULTS：EE的总体患病率为4.5%（95%CI，3.3%-6.0%）的受试者特定的性状。EE组受试者的氧饱和度显著低于非EE组受试者（85.3% vs 90.1%，P <0.001），但两组之间的铁状态指标无差异（所有值均P > 0.09）。在多变量logistic回归中，我们发现年龄>= 65岁（OR = 2.45，95%CI，1.16-5.09），男性（3.86，1.78-9.08），患有代谢综合征（2.66，1.27-5.75）或超重（5.20，1.95-16.77），脉搏血氧饱和度< 85%（14.90，6.43-34.90），%预测FVC < 80%（13.62，4.40-41.80）与EE密切相关。EE的归因分数以超重最大（26.7%），其次是男性（21.5%）、脉搏血氧仪< 85%（16.4%）、患有代谢综合征（14.4%）、%预测FVC < 80%（9.3%）。结论：我们发现秘鲁安第斯山脉EE的患病率低于之前的报告。尽管低氧血症和肺活量下降与红细胞过多密切相关，但超重或患有代谢综合征与我们研究人群中的一部分病例相关。
BACKGROUND: Excessive erythrocytosis (EE) is a prevalent condition in populations living at high altitudes (> 2,500 m above sea level). Few large population-based studies have explored the association between EE and multiple subject-specific traits including oxygen saturation, iron status indicators, and pulmonary function.METHODS: We enrolled a sex-stratified and age-stratified sample of 1,065 high-altitude residents aged >= 35 years from Puno, Peru (3,825 m above sea level) and conducted a standardized questionnaire and physical examination that included spirometry, pulse oximetry, and a blood sample for multiple clinical markers. Our primary objectives were to estimate the prevalence of EE, characterize the clinical profile and iron status indicators of subjects with EE, and describe subject-specific traits associated with EE.RESULTS: Overall prevalence of EE was 4.5% (95% CI, 3.3%-6.0%). Oxygen saturation was significantly lower among EE than non-EE group subjects (85.3% vs 90.1%, P < .001) but no difference was found in iron status indicators between both groups (P > .09 for all values). In multivariable logistic regression, we found that age >= 65 years (OR = 2.45, 95% CI, 1.16-5.09), male sex (3.86, 1.78-9.08), having metabolic syndrome (2.66, 1.27-5.75) or being overweight (5.20, 1.95-16.77), pulse oximetry < 85% (14.90, 6.43-34.90), and % predicted FVC < 80% (13.62, 4.40-41.80) were strongly associated with EE. Attributable fractions for EE were greatest for being overweight (26.7%), followed by male sex (21.5%), pulse oximetry < 85% (16.4%), having metabolic syndrome (14.4%), and % predicted FVC < 80% (9.3%).CONCLUSIONS: We found a lower prevalence of EE than in previous reports in the Peruvian Andes. Although the presence of hypoxemia and decreased vital capacity were strongly associated with excessive erythrocytosis, being overweight or having metabolic syndrome were associated with an important fraction of cases in our study population.