Lung volume, chest size, and hematological variation in low-, medium-, and high-altitude central Asian populations

Ancestral Origins and Admixture History of Kazakhs

Kazakh people, like many other populations that settled in Central Asia, demonstrate an array of mixed anthropological features of East Eurasian (EEA) and West Eurasian (WEA) populations, indicating a possible scenario of biological admixture between already differentiated EEA and WEA populations. However, their complex biological origin, genomic makeup, and genetic interaction with surrounding populations are not well understood. To decipher their genetic structure and population history, we conducted, to our knowledge, the first whole-genome sequencing study of Kazakhs residing in Xinjiang (KZK). We demonstrated that KZK derived their ancestries from 4 ancestral source populations: East Asian (∼39.7%), West Asian (∼28.6%), Siberian (∼23.6%), and South Asian (∼8.1%). The recognizable interactions of EEA and WEA ancestries in Kazakhs were dated back to the 15th century BCE. Kazakhs were genetically distinctive from the Uyghurs in terms of their overall genomic makeup, although the 2 populations were closely related in genetics, and both showed a substantial admixture of western and eastern peoples. Notably, we identified a considerable sex-biased admixture, with an excess of western males and eastern females contributing to the KZK gene pool. We further identified a set of genes that showed remarkable differentiation in KZK from the surrounding populations, including those associated with skin color (SLC24A5, OCA2), essential hypertension (HLA-DQB1), hypertension (MTHFR, SLC35F3), and neuron development (CNTNAP2). These results advance our understanding of the complex history of contacts between Western and Eastern Eurasians, especially those living or along the old Silk Road.

Genotyped indigenous Kiwcha adults at high altitude are lighter and shorter than their low altitude counterparts

Background

Anthropometric measures have been classically used to understand the impact of environmental factors on the living conditions of individuals and populations. Most reference studies on development and growth in which anthropometric measures were used were carried out in populations that are located at sea level, but there are few studies carried out in high altitude populations.

Objective

The objective of this study was to evaluate the anthropometric and body composition in autochthonous Kiwcha permanently living at low and high altitudes.

Methodology

A cross-sectional study of anthropometric and body composition between genetically matched lowland Kiwcha from Limoncocha (n = 117), 230 m in the Amazonian basin, and high-altitude Kiwcha from Oyacachi (n = 95), 3800 m in Andean highlands. Student’s t-test was used to analyze the differences between continuous variables, and the chi-square test was performed to check the association or independence of categorical variables. Fisher’s exact test or Spearman’s test was used when the variable had evident asymmetries with histograms prior to the selection of the test.

Results

This study shows that high altitude men are shorter than their counterparts who live at low altitude, with p = 0.019. About body muscle percentage, women at high altitudes have less body muscle percentage (− 24.8%). In comparison, men at high altitudes have significantly more muscle body mass percentage (+ 13.5%) than their lowland counterparts. Body fat percentage was lower among low altitude women (− 15.5%), and no differences were found among men.

Conclusions

This is the first study to be performed in two genotyped controlled matching populations located at different altitudes to our best knowledge. The anthropometric differences vary according to sex, demonstrating that high altitude populations are, in general, lighter and shorter than their low altitude controls. Men at high altitude have more muscled bodies compared to their lowland counterparts, but their body age was older than their actual age.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40101-022-00280-6.

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Background

The reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization.

Objective

The objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude.

Methodology

A cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3180 m) in Andean highlands. The sample size estimates permitted to recruited 118 patients (40 men and 78 women) from Limoncocha and 95 (39 men and 56 women) from Oyacachi. Chi-square method was used to analyze association or independence of categorical variables, while Student’s t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn’t meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups.

Results

The FVC and the FEV₁ were significantly greater among highlanders than lowlanders (p value < 0.001), with a proportion difference of 15.2% for men and 8.5% for women. The FEV₁/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants.

Conclusion

Residents of Oyacachi had greater FVC and FEV₁ than their peers from Limoncocha, a finding physiologically plausible according to published literature. Lung size and greater ventilatory capacities could be an adaptive mechanism developed by the highlander in response to hypoxia. Our results support the fact that this difference in FVC and FEV₁ is a compensatory mechanism towards lower barometric and alveolar partial pressure of oxygen pressure.

Comparing Spirometric Reference Values From Childhood to Old Age Estimated by LMS and Linear Regression Models

BACKGROUND

Proper reference values for lung function testing are essential for achieving adequate interpretations. The LMS procedure (lambda, mu, sigma) permits continuous analyses of entire populations avoiding gaps in the transition between childhood and adulthood. It also allows more precise calculations of average values, dispersion, and 5th percentiles, which are usually considered the lower limit of normality. The objective of this study was to compare our results fitted with the LMS method with standard multiple linear regression, and with those from international Global Lung Function Initiative (GLI) equations.

METHODS

Data from 9835 healthy residents of the metropolitan area of Mexico City aged 8-80 years were compiled from several studies: EMPECE, PLATINO, adult Mexican workers and two unpublished studies. The LMS procedure and multiple linear regression models were fit to obtain reference equations using R software.

RESULTS

Residuals from the LMS models had a median closer to zero, and smaller dispersion than those from the linear model, but differences although statistically significant were very small and of questionable practical relevance. For example, for females and ln(FEV₁), median residual was -0.001 with p25 of -0.08 and p75 of 0.08 for LMS, compared with 0.004 (-0.08, 0.09) [p<0.05] for the linear model. Average spirometric values for a given height for our population, were higher than those predicted by the GLI study.

CONCLUSION

Continuous reference equations for the Mexican population calculated using the LMS technique showed slightly better fit than linear regression models.

Spirometry in Central Asian Lowlanders and Highlanders, a Population Based Study

Introduction: The purpose of the study was to establish spirometric reference values for a Central Asian population of highlanders and lowlanders.

Methods: Spirometries from a population-based cross-sectional study performed in 2013 in rural areas of Kyrgyzstan were analyzed. Using multivariable linear regression, Global Lung Function Initiative (GLI) equations were fitted separately for men and women, and altitude of residence (700–800 m, 1,900–2,800 m) to data from healthy, never-smoking Kyrgyz adults. The general GLI equation was applied: Predicted value=ea0+a1× ln(Height)+a2× ln(Age)+b1× ln(Age100)+b2× ln(Age100)2+b3× ln(Age100)3            +b4× ln(Age100)4+b5× ln(Age100)5

Results: Of 2,784 screened Kyrgyz, 448 healthy, non-smoking highlanders (379 females) and 505 lowlanders (368 females), aged 18–91 years, were included. Predicted FVC in Kyrgyz fit best with GLI “North-East Asians,” predicted FEV₁ fit best with GLI “Other/Mixed.” Predicted FEV₁/FVC was lower than that of all GLI categories. Age- and sex-adjusted mean FVC and FEV₁ were higher in highlanders (+0.138l, +0.132l) than in lowlanders (P < 0.001, all comparisons), but FEV₁/FVC was similar.

Conclusion: We established prediction equations for an adult Central Asian population indicating that FVC is similar to GLI “North-East Asian” and FEV₁/FVC is lower than in all other GLI population categories, consistent with a relatively smaller airway caliber. Central Asian highlanders have significantly greater dynamic lung volumes compared to lowlanders, which may be due to environmental and various other effects.

The increase in hemoglobin concentration with altitude varies among human populations

Decreased oxygen availability at high altitude requires physiological adjustments allowing for adequate tissue oxygenation. One such mechanism is a slow increase in the hemoglobin concentration ([Hb]) resulting in elevated [Hb] in high-altitude residents. Diagnosis of anemia at different altitudes requires reference values for [Hb]. Our aim was to establish such values based on published data of residents living at different altitudes by applying meta-analysis and multiple regressions. Results show that [Hb] is increased in all high-altitude residents. However, the magnitude of increase varies among the regions analyzed and among ethnic groups within a region. The highest increase was found in residents of the Andes (1 g/dL/1000 m), but this increment was smaller in all other regions of the world (0.6 g/dL/1000 m). While sufficient data exist for adult males and females showing that sex differences in [Hb] persist with altitude, data for infants, children, and pregnant women are incomplete preventing such analyses. Because WHO reference values were originally based on [Hb] of South American people, we conclude that individual reference values have to be defined for ethnic groups to reliably diagnose anemia and erythrocytosis in high-altitude residents. Future studies need to test their applicability for children of different ages and pregnant women.

Anthropometric and hematological tests to diagnose nutritional deficiencies in schoolchildren of indigenous communities living in the Andean region of Ecuador

ABSTRACT Objective To carry out the anthropometric and biometric-hematological assessments in schoolchildren of the Andean region of Ecuador, in order to improve the diagnosis of nutritional deficiencies. Methods The study has been carried out in the San Juan School (Chimborazo, Ecuador), located at 3,240m of altitude, to 36 children of 5 and 6 years old. Anthropometric analyses (weight, height and body mass index), and hematocrit and hemoglobin concentrations were measured. The hemoglobin measurement was evaluated considering the normal value and the one adapted to the altitude of the area. Results The schoolchildren showed high prevalence of stunting (44%). The values of hematocrit (.=0.001) and hemoglobin (.=0.003) were higher in girls. It should be highlighted that using the normal value of hemoglobin, anemia was not detected. However almost a fifth of the schoolchildren studied were diagnosed with anemia when we applied the correction factors adapted to the altitude. Conclusion The use of correction factors adapted to the altitude is considered essential to do the hematology test in populations that live in high altitude in order to avoid a false diagnosis. Moreover, it is necessary to establish the environmental factors related to the stunted growth of this population of the Andean region.

Hematocrit of mammals (Artiodactyla, Carnivora, Primates) at 1500m and 2100m altitudes

The rise in hematocrit (Hct) is one of the hallmarks of human acclimatization to high altitude and, in chronic conditions, reflects the hypoxia-induced polycythemia. However, it is not a uniform response among domestic species and it is not found in Andean camelids, species long adapted to high altitudes. Hence, we asked to what extent the polycythemia of humans is common among mammals. Hct data were collected from captive mammals of three orders (Primates, Artiodactyla, Carnivora), 70 specimens of 33 species at ∼1500m altitude (barometric pressure Pb=635mmHg) and 296 specimens of 64 species at ∼2100m (Pb=596mmHg), long-term residents at those altitudes. Sea level values and data in men and women at the corresponding altitudes were from a compilation of literature sources. At either altitude Hct was significantly higher than at sea level both in men and women; the increase (ΔHct) for genders combined averaged 3.4% (±0.7 SEM) at 1500m and 5.4% (±0.3) at 2100m. Differently, among the three mammalian orders studied a significant increase in Hct occurred only in females of Carnivora (at 1500m) and in males of Primates (at 2100m). The average ΔHct of all species combined was 0.8% (±0.7) at 1500m and 1.5% (±0.4) at 2100m, both significantly less than in humans (P<0.001). At 2100m the average ΔHct of nine species long adapted to high altitude was 0.4% (±1), significantly less than in non-adapted species (P<0.001). A polycythemic response like that of men and women at 2100m occurred in less than 10% of the mammals examined. We conclude that, at least for the altitudes studied, a minimal polycythemia is a general feature of both high-altitude adapted and non-adapted species, and the magnitude of the human response is exceptional among mammals.

Effect of acute exposure to moderate altitude on muscle power: hypobaric hypoxia vs. normobaric hypoxia

When ascending to a higher altitude, changes in air density and oxygen levels affect the way in which explosive actions are executed. This study was designed to compare the effects of acute exposure to real or simulated moderate hypoxia on the dynamics of the force-velocity relationship observed in bench press exercise. Twenty-eight combat sports athletes were assigned to two groups and assessed on two separate occasions: G1 (n = 17) in conditions of normoxia (N1) and hypobaric hypoxia (HH) and G2 (n = 11) in conditions of normoxia (N2) and normobaric hypoxia (NH). Individual and complete force-velocity relationships in bench press were determined on each assessment day. For each exercise repetition, we obtained the mean and peak velocity and power shown by the athletes. Maximum power (Pmax) was recorded as the highest P(mean) obtained across the complete force-velocity curve. Our findings indicate a significantly higher absolute load linked to P(max) (∼ 3%) and maximal strength (1 RM) (∼ 6%) in G1 attributable to the climb to altitude (P<0.05). We also observed a stimulating effect of natural hypoxia on P(mean) and P(peak) in the middle-high part of the curve (≥ 60 kg; P<0.01) and a 7.8% mean increase in barbell displacement velocity (P<0.001). No changes in any of the variables examined were observed in G2. According to these data, we can state that acute exposure to natural moderate altitude as opposed to simulated normobaric hypoxia leads to gains in 1 RM, movement velocity and power during the execution of a force-velocity curve in bench press.

Predictive models and spatial variations of vital capacity in healthy people from 6 to 84 years old in China based on geographical factors

The aim of this study was to provide a scientific basic for a unified standard of the reference value of vital capacity (VC) of healthy subjects from 6 and 84 years old in China. The normal reference value of VC was correlated to seven geographical factors, including altitude (X1), annual duration of sunshine (X2), annual mean air temperature (X3), annual mean relative humidity (X4), annual precipitation amount (X5), annual air temperature range (X6) and annual mean wind speed (X7). Predictive models were established by five different linear and nonlinear methods. The best models were selected by t-test. The geographical distribution map of VC in different age groups can be interpolated by Kriging's method using ArcGIS software. It was found that the correlation of VC and geographical factors in China was quite significant, especially for both males and females aged from 6 to 45. The best models were built for different age groups. The geographical distribution map shows the spatial variations of VC in China precisely. The VC of healthy subjects can be simulated by the best model or acquired from the geographical distribution map provided the geographical factors for that city or county of China are known.

Physiological responses and evaluation of effects of BMI, smoking and drinking in high altitude acclimatization: a cohort study in Chinese Han young males

High altitude acclimatization is a series of physiological responses taking places when subjects go to altitude. Many factors could influence these processes, such as altitude, ascending speed and individual characteristics. In this study, based on a repeated measurement design of three sequential measurements at baseline, acute phase and chronic phase, we evaluated the effect of BMI, smoking and drinking on a number of physiological responses in high altitude acclimatization by using mixed model and partial least square path model on a sample of 755 Han Chinese young males. We found that subjects with higher BMI responses were reluctant to hypoxia. The effect of smoking was not significant at acute phase. But at chronic phase, red blood cell volume increased less while respiratory function increased more for smoking subjects compared with nonsmokers. For drinking subjects, red blood cell volume increased less than nondrinkers at both acute and chronic phases, while blood pressures increased more than nondrinkers at acute phase and respiratory function, red blood cell volume and oxygen saturation increased more than nondrinkers at chronic phase. The heavy and long-term effect of smoking, drinking and other factors in high altitude acclimatization needed to be further studied.

Height, weight and body mass index percentiles of children aged 6-14 years living at moderate altitudes

OBJECTIVE

Individuals living at high altitudes are reported to have lower stature and also a smaller chest size in relation to their stature. Altitude-related hypobaric hypoxia is considered to be the major cause of these alterations in growth, but adverse socioeconomic and/or other environmental conditions may also have a role in poor growth performance. This study was undertaken to provide growth data on children and adolescents living in a moderate-altitude area in Turkey.

METHODS

The dataset of an anthropometric study conducted among a population living in a city at an altitude of 2000 meters was analyzed. A total of 1638 children and adolescents (871 males and 767 females) aged between 6 and 14 years were included in this study. The LMS method was used in the analysis and percentile values corresponding to the 3rd, 5th, 10th, 15th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles for height, weight and body mass index (BMI) were estimated. The results were compared with the measurements of children and adolescents living in areas of lower altitude in Turkey.

RESULTS

Starting at ages 0-10 years, height, weight and BMI values of children and adolescents of both genders living at an altitude of 2000 meters were noticeably lower than those reported for their counterparts living in areas of lower altitude in Turkey.

CONCLUSIONS

The higher values for height, weight and BMI in children living in low-altitude areas can be attributed to altitude effect, but socioeconomic and microclimate effects cannot be discarded and further studies are needed.

Effects of hypoxia on muscle protein synthesis and anabolic signaling at rest and in response to acute resistance exercise

Chronic reductions in tissue O(2) tension (hypoxia) are associated with muscle atrophy and blunted hypertrophic responses to resistance exercise (RE) training. However, the effect of hypoxia on muscle protein synthesis (MPS) at rest and after RE is unknown. In a crossover study, seven healthy men (21.4 ± 0.7 yr) performed unilateral leg RE (6 × 8 repetitions at 70% 1-repetition maximum) under normoxic (20.9% inspired O(2)) and normobaric hypoxic (12% inspired O(2) for 3.5 h) postabsorptive conditions. Immediately after RE the rested leg was biopsied, and a primed continuous infusion of [1,2-(13)C(2)]leucine was maintained for 2.5 h before final biopsies from both legs to measure tracer incorporation and signaling responses (i.e., ribosomal S6 kinase 1). After 3.5 h of hypoxia, MPS was not different from normoxia in the rested leg (normoxia 0.033 ± 0.016 vs. hypoxia 0.043 ± 0.016%/h). MPS increased significantly from baseline 2.5 h after RE in normoxia (0.033 ± 0.016 vs. 0.104 ± 0.038%/h) but not hypoxia (0.043 ± 0.016 vs. 0.060 ± 0.063%/h). A significant linear relationship existed between MPS 2.5 h after RE in hypoxia and mean arterial blood O(2) saturation during hypoxia (r(2) = 0.49, P = 0.04). Phosphorylation of p70S6K(Thr389) remained unchanged in hypoxia at rest but increased after RE in both normoxia and hypoxia (2.6 ± 1.2-fold and 3.4 ± 1.1-fold, respectively). Concentrations of the hypoxia-responsive mTOR inhibitor regulated in development and DNA damage-1 were unaltered by hypoxia or RE. We conclude that normobaric hypoxia does not reduce MPS over 3.5 h at rest but blunts the increased MPS response to acute RE to a degree dependent on extant SpO(2).

Prevalence of overweight and cardiovascular risk factors in rural and urban children from Central Asia: the Kazakhstan health and nutrition examination survey

Kazakhstan is undergoing a rapid modernization process, which carries the risk of an epidemic of obesity and cardiovascular disease. We enrolled a sample of about 50 children for every combination of gender, environment (urban vs. rural), ethnic group (Kazakh vs. Russian), and age group from 7 to 18 years, for a total of 4,808 children. Anthropometry and blood pressure were measured on all children while fasting blood cholesterol and glucose were measured only in 2,616 children aged > or =12 years. The prevalence of overweight and risk of overweight ranged from 2.8 (rural male Kazakhs) to 9.1% (urban male Russians). The prevalence of prehypertension and hypertension ranged from 8.3 (urban females) to 15.9% (rural females); that of hypercholesterolemia from 11.5 (male rural Russians) to 26.5% (female rural Kazakhs); and the overall prevalence of impaired fasting glucose was 0.1%. We conclude that overweight and cardiovascular risk factors are less prevalent in children living in Kazakhstan than in those living in Western countries. However, these figures are not negligible and suggest that preventive measures are needed to contain the epidemic of overweight and cardiovascular disease that will most likely accompany the modernization of Kazakhstan in the next years.

Spirometric reference values for children and adolescents from Kazakhstan

BACKGROUND

Spirometric parameters are influenced by several factors and many reference data are available in the literature. However, no spirometric data are available for children and adolescents from Central Asia.

AIM

The study aimed to calculate spirometric reference curves on the basis of anthropometry, ethnicity (Kazakh vs. Russian) and living environment (urban vs. rural).

SUBJECTS AND METHODS

Spirometry (FEV1, FVC and FEF25-75%) was performed and anthropometric measurements taken for 1926 male and 1967 female Kazakh children aged 7-18 years.

RESULTS

Height explained almost all the variance of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) for both sexes, while age and inspiratory circumference contributed slightly to the prediction. Moreover, FVC and FEV1 were greater in Russians than in Kazakhs and ethnicity did enter the prediction model for these parameters. The living environment had a marginal effect on spirometry. In fact, forced expiratory flow 25-75% (FEF25-75%) was slightly higher in urban than in rural females, FVC was slightly higher in rural than in urban males, while FEV1 was not affected. Finally, among several spirometric equations available in the literature, those performing better in our children were obtained in developed countries.

CONCLUSION

Anthropometry was the most important predictor of spirometry. Age and ethnicity were also predictors, while the contribution of the living environment was more limited.

Morphological growth and thorax dimensions among Tibetan compared to Han children, adolescents and young adults born and raised at high altitude

BACKGROUND

Studies comparing the growth of indigenous high-altitude Aymara children and children of low-altitude European descent who have been born and raised at high altitude in the Andes have provided evidence for genetically-determined differences in thorax growth, as well as for population differences in height, weight and other measures of overall size. Comparable studies now can be undertaken in Asia because of the growing number of Han Chinese who have been born and raised at high altitude on the Qinghai-Tibetan Plateau.

AIM

The study compares the growth of indigenous Tibetan children and children of Han descent who have been born and raised at the same high altitudes, and under similar socio-economic conditions.

SUBJECTS AND METHODS

Measurements of stature, sitting height, weight, triceps and subscapular skinfolds, upper arm muscle area, transverse chest diameter, anterio-posterior chest diameter, and chest circumference were taken on 1439 Tibetan and Han males and females between the ages of 6 and 29 years who were born and raised 3200 m, 3800 m or at 4300 m in the high altitude province of Qinghai in western China.

RESULTS

Han-Tibetan differences in body size do not occur systematically for any measurement, for any age group, or for either gender; nor is there a systematic pattern of body size differences between 3200 m and 4300 m. This indicates that there are no differences in general growth between the two groups at high altitude in Qinghai, although both groups grow more slowly than urban children at low altitude in China. On the other hand, Tibetan males possess significantly deeper chests than Han males, and Tibetan females possess significantly wider chests than Han females. Tibetans of both sexes possess significantly larger chest circumferences than Han males and females.

CONCLUSIONS

Although genetic similarities cannot be ruled out, comparable dietary stress is a likely explanation for the similar and slow morphological growth of Han and Tibetans at high altitude. However, Han-Tibetan differences in thorax dimensions are likely a consequence of population (genetic) differences in the response to hypoxia during growth.

Unravelling migrations in the steppe: mitochondrial DNA sequences from ancient central Asians

This study helps to clarify the debate on the Western and Eastern genetic influences in Central Asia. Thirty-six skeletal remains from Kazakhstan (Central Asia), excavated from different sites dating between the fifteenth century BC to the fifth century AD, have been analysed for the hypervariable control region (HVR-I) and haplogroup diagnostic single nucleotide polymorphisms (SNPs) of the mitochondrial DNA genome. Standard authentication criteria for ancient DNA studies, including multiple extractions, cloning of PCR products and independent replication, have been followed. The distribution of east and west Eurasian lineages through time in the region is concordant with the available archaeological information: prior to the thirteenth-seventh century BC, all Kazakh samples belong to European lineages; while later an arrival of east Eurasian sequences that coexisted with the previous west Eurasian genetic substratum can be detected. The presence of an ancient genetic substratum of European origin in West Asia may be related to the discovery of ancient mummies with European features in Xinjiang and to the existence of an extinct Indo-European language, Tocharian. This study demonstrates the usefulness of the ancient DNA in unravelling complex patterns of past human migrations so as to help decipher the origin of present-day admixed populations.

Growth of Han migrants at high altitude in central Asia

Han Chinese of low-altitude descent have been living in Qinghai Province of Western China for at least two millennia. For most of this time they have lived at elevations under 2,500 m. However, during the last four decades an increasing number of Han have moved into high-altitude towns at elevations over 3,000 m, and some above 4,000 m. There are now sufficient numbers of Han descendants who have been born and raised at high altitude to allow a comparison of their morphological and physiological growth patterns with low-altitude Han to detect the effect of hypoxia. The field study reported here was conducted by collaborating Chinese and American researchers over a 6-year period, and included 1,227 Han living at high altitude in Qinghai and at low altitude near Beijing. This study demonstrates that Han born and raised at high altitude are smaller and lighter than those at low altitude-particularly as children and adolescents. Slower growth at high altitude may be a consequence of hypoxia, but it also corresponds to poorer economic conditions in rural Qinghai Province, and thus may reflect nutritional inadequacies. Differences in altitude and/or nutrition do not seem to affect thorax dimensions, since, relative to stature, chest dimensions are similar at both high and low altitudes. Nevertheless, lung volumes are higher among Han at high altitude, possibly reflecting the influence of hypoxia on alveolar growth. The hematological values of Han growing up at 3,200 m are not different from those at low altitude-an unusual finding relative to other low-altitude groups that may reflect population differences in response to hypoxia. At 3,800 m and 4,300 m, however, Han show elevated hemoglobin relative to Han at low altitude.

Spirometry values in Himalayan high altitude residents (Sherpas)

We compared the spirometric values of the isolated racial group of Himalayan Sherpas with those predicted for the European Coal and Steel Community (EC&S). 146 normal adult Sherpas (64 males, 82 females) and 103 adolescents (37 females and 66 males, age 10-18 years) resident at an altitude of 3,840 m were studied. Predicted values for each adult individual were calculated using the EC&S reference equations and separate Caucasian values for children were used, and new predictive equations for the Sherpa population derived. The FEV(1) of boys, adult male and female Sherpas are all significantly greater than predicted (% Predicted (PP) (95% Confidence Interval (CI)), 113% (110-116), 110% (107-114) and 116% (112-121), P < 0.0001 for all groups) as is forced vital capacity (FVC) (112% (111-119), 113% (109-117) and 121% (117-125) respectively, P < 0.0001 for all groups). Sherpa girls displayed a smaller difference in FEV(1) and FVC (PP(CI), 104% (99-109) P<0.1 and 108% (103-114) P = 0.005, respectively). We conclude that the Sherpa race has significantly larger spirometric values than Caucasians. We speculate that this is an adaptation in response to chronic hypoxia and high levels of habitual exercise.

Lung function of Han Chinese born and raised near sea level and at high altitude in Western China

Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV(1)), and FEV(1)/FVC ratios were determined for 531 individuals of Han Chinese descent living at low altitude (250 m) near Beijing and for 592 individuals of Han descent who were born and raised at three high altitudes (3,200 m, 3,800 m, 4,300 m) in Qinghai Province, P.R.C. The study included males and females, ages 6-51 years. Thorax widths, depths, and circumferences of Han females and males born and raised at high altitude are similar to those of low-altitude Han. On the other hand, high-altitude children and adolescents have larger relative sitting heights, indicating greater thorax lengths. After adjusting for this variation in morphology, mean FVC values among 6-21 year-old Han at high altitude are only between 136 mL (for females) and 173 ml (for males) greater than those determined at low altitude but the differences are statistically significant and are maintained consistently throughout the growth period. These data indicate that growth at high altitude produces small-to-moderate increases in lung volumes (about 6%) relative to genetically similar groups growing up at low altitude. In addition, there is no evidence that lung volume growth is accelerated relative to morphological growth among Han children born and raised at high altitude. Adults, 22-51 years, also show greater FVC values at high altitude but the size of the increase relative to Han at low altitude is variable (3% in males and 11% in females). Greater lung function at high altitude is unlikely to result from increased activity or lower pollution, and thus appears to be primarily a result of development in a hypoxic environment. Differences in FVC and FEV(1) at 3,200 m, 3,800 m, and 4,300 m are generally not significant, so that living at altitudes between 3,200 m and 4,300 m appears to have little additional effect on volumetric growth.

Body size, composition, and blood pressure of high-altitude Quechua from the Peruvian Central Andes (Huancavelica, 3,680 m)

Although much information is available about the effects of high altitude on physiological characteristics, less is know about its effect on body composition. In the present study, anthropometric and body composition variables were investigated in a sample of 77 adult Quechua males from the Peruvian Central Andes (Huancavelica, 3,680 m). The subjects are shorter in relation to body weight than other ethnic groups, whereas body proportions are macrocormic (indicating a long trunk relative to the lower extremities), with intermediate values of the acromial-iliac index. All skinfold thicknesses are low (approximately 15th percentiles of NHANES reference values for the triceps and subscapular skinfolds), but tend to be higher than in the other Quechua populations. Similar results are obtained when percentage fat is estimated. Somatotypes are dominant in mesomorphy with very low ectomorphy. Comparison with a sample of high-altitude Kirghiz (3,200 m), previously studied with the same methods, shows higher values in the Peruvian sample for all variables related to adiposity. The presence of low adiposity in the Quechua population could be associated with stresses of the high-altitude environment. Mean values of blood pressure are very low and there is no correlation with age.