Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders
Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders
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DOI：
10.1089/ham.2017.0123
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发表时间：
2018-05-21
影响因子：
2.1
通讯作者：
Villafuerte, Francisco C.
中科院分区：
文献类型：
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作者：
Corante, Noemi;Anza-Ramirez, Cecilia;Villafuerte, Francisco C.
心血管疾病是全世界死亡的主要原因。与海平面居民相比，生活在高海拔（HA）缺氧条件下的高地居民被认为能提供天然的保护，防止心血管和代谢疾病。然而，一些HA居民变得对慢性缺氧不耐受并发展称为慢性高山病（CMS）的进行性失能综合征，其特征在于过度红细胞增多（EE;男性Hb >= 21 g/dL，女性Hb 19 g/dL）。来自HA研究的证据表明，除了CMS的典型体征和症状外，这些高地人还可能患有代谢和心血管疾病。因此，我们假设这种综合征也与在健康高地人（HH）中观察到的心脏代谢保护的丧失有关，因此与更高的心血管风险（CVR）有关。本工作的目的是评估之间的关联EE和CVR计算使用Fragrance一般CVR评分和EE和CVR因素之间的男性高地人。这项横断面研究包括来自秘鲁海拔4340米（HH = 209，CMS = 133）的塞罗德帕斯科的342名男性。通过调整潜在混杂因素（BMI、脉搏血氧饱和度和年龄）的多重logistic回归评估相关性。校正后的模型显示，高地人EE患者的高CVR（>20%）几率是HH患者的3.63倍（CI 95%：1.22-10.78; p = 0.020），EE与高血压、空腹血糖升高、胰岛素抵抗和空腹血清甘油三酯升高相关。我们的研究结果表明，患有EE的人与健康的人相比，发生心血管事件的风险增加。
Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb >= 21 g/dL in men, Hb 19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22-10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.