Failure of polycythemia-induced increase in arterial oxygen content to suppress the anorexic effect of simulated high altitude in the adult rat

An ecological study on the spatially varying association between adult obesity rates and altitude in the United States: using geographically weighted regression

In this research, we evaluated the relationship between obesity rates and altitude using a cross-county study design. We applied a geographically weighted regression (GWR) to examine the spatially varying association between adult obesity rates and altitude after adjusting for four predictor variables including physical activity. A significant negative relationship between altitude and adult obesity rates were found in the GWR model. Our GWR model fitted the data better than OLS regression (R² = 0.583), as indicated by an improved R² (average R² = 0.670; range: 0.26-0.77) and a lower Akaike Information Criteria (AIC) value (14,736.88 vs. 15,386.59 in the OLS model). These approaches, evidencing spatial varying associations, proved very useful to refine interpretations of the statistical output on adult obesity. This study underscored the geographic variation in relationships between adult obesity rates and mean county altitude in the United States. Our study confirmed a varying overall negative relationship between county-level adult obesity rates and mean county altitude after taking other confounding factors into account.

Tualang Honey Ameliorates Hypoxia-induced Memory Deficits by Reducing Neuronal Damage in the Hippocampus of Adult Male Sprague Dawley Rats

Objectives

A growing body of evidence indicates that hypoxia exposure causes learning and memory deficits. An effective natural therapeutic approach has, however, not been explored widely. Our previous studies found that Tualang honey administration protected learning and memory functions in ovariectomized rats. Therefore, the present study investigated its efficacy in ameliorating hypoxia-induced memory deficits in adult male Sprague Dawley rats.

Materials and Methods

The rats were divided into four groups: i) Normoxia treated with sucrose (n=12), ii) Normoxia treated with Tualang honey (n=12), iii) Hypoxia treated with sucrose (n=12), and iv) Hypoxia treated with Tualang honey (n=12). Tualang honey (0.2 g/kg/BW) and sucrose (1 mL of 7.9%) supplementations were administered orally to the rats daily for 14 days. Then the hypoxia groups were exposed to hypoxia (~11%) for 7 days, while the normoxia groups were kept in normal conditions. Following exposure to hypoxia, the rats' memories were analyzed using a novel object recognition task and T-maze test.

Results

The data revealed that rats exposed to hypoxia showed significant impairment in short-term memory (STM), spatial memory (p<0.01), and long-term memory (LTM) when compared to the normoxia group. Hypoxia rats treated with Tualang honey showed significant improvement in STM, LTM, and spatial memory (p<0.05) compared with those treated with sucrose (p<0.05). Tualang honey also reduced neuronal damage in the hippocampus of adult male Sprague Dawley rats exposed to hypoxia.

Conclusion

It is suggested that Tualang honey pretreatment has protective effects against hypoxia-induced memory deficits, possibly through its antioxidant contents.

Gestational and early postnatal exposure to simulated high altitude does not modify postnatal body mass growth trajectory in the rat

Postnatal hypoxia blunts body mass growth. It is also known that the quality of the fetal environment can influence the subsequent adult phenotype. The main purpose of the study was to determine whether gestational hypoxia and early postnatal hypoxia are able to blunt growth when the offspring is raised under normoxia. Hypobaric hypoxia was induced in simulated high altitude (SHA) chambers in which air was maintained at 380 mmHg (5450 m). Mature Sprague-Dawley rats of both sexes were divided in normoxic (NX) and hypoxic (HX) groups and, in the case of the HX group, maintained for 1 month at 5450 m. Mating was then allowed under NX or HX conditions. Offspring were NX-NX, NX-HX, HX-HX, or HX-NX: the first term indicates NX or HX during both gestation and the first 30 days of life; the second term indicates NX or HX during postnatal life between days 30 and 133. Body mass (g) was measured periodically and body mass growth rate (BMGR, g/d) was estimated between days 33 and 65 of postnatal life. Results can be summarized as follows: 1) BM was significantly higher in NX than in HX rats at weaning; 2) BMGR was not significantly different between NX-NX and HX-NX rats, and between HX-HX and NX-HX animals; and 3) BMGR was significantly higher in rats living under NX conditions than in those living under HX conditions during postnatal life. Data suggest that that hypobaric hypoxia during gestational and early postnatal development of rats does not alter the regulation of body mass growth in rats when compared to that seen under sea-level conditions.

Muscle RING finger-1 promotes a maladaptive phenotype in chronic hypoxia-induced right ventricular remodeling

Exposure to chronic hypoxia (CH) induces elevated pulmonary artery pressure/resistance, leading to an eventual maladaptive right ventricular hypertrophy (RVH). Muscle RING finger-1 (MuRF1) is a muscle-specific ubiquitin ligase that mediates myocyte atrophy and has been shown to play a role in left ventricular hypertrophy and altered cardiac bioenergetics in pressure overloaded hearts. However, little is known about the contribution of MuRF1 impacting RVH in the setting of CH. Therefore, we hypothesized that MuRF1 deletion would enhance RVH compared to their wild-type littermates, while cardiac-specific overexpression would reduce hypertrophy following CH-induced pulmonary hypertension. We assessed right ventricular systolic pressure (RVSP), right ventricle to left ventricle plus septal weight ratio (RV/LV+S) and hematocrit (Hct) following a 3-wk isobaric CH exposure. Additionally, we conducted dual-isotope SPECT/CT imaging with cardiac function agent ²⁰¹Tl-chloride and cell death agent ^99mTc-annexin V. Predictably, CH induced pulmonary hypertension, measured by increased RVSP, RV/LV+S and Hct in WT mice compared to normoxic WT mice. Normoxic WT and MuRF1-null mice exhibited no significant differences in RVSP, RV/LV+S or Hct. CH-induced increases in RVSP were also similar between WT and MuRF1-null mice; however, RV/LV+S and Hct were significantly elevated in CH-exposed MuRF1-null mice compared to WT. In cardiac-specific MuRF1 overexpressing mice, RV/LV+S increased significantly due to CH exposure, even greater than in WT mice. This remodeling appeared eccentric, maladaptive and led to reduced systemic perfusion. In conclusion, these results are consistent with an atrophic role for MuRF1 regulating the magnitude of right ventricular hypertrophy following CH-induction of pulmonary hypertension.

Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation

We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level) duty assignment with low altitude (<0.98 kilometers). The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54) by Cox regression. We found service members had a lower hazard ratio (HR) of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54–0.65; p<0.001). Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study) also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s) of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.

Ghrelin and leptin levels of sojourners and acclimatized lowlanders at high altitude

The circulatory levels of two appetite regulatory hormones i.e. leptin and ghrelin were estimated in sojourners and acclimatized subjects to investigate their possible role in high altitude (HA) induced anorexia. A group of 30 lowlanders who had never visited HA were inducted to a height of 3600 m by air and after 48 h they were further taken to an altitude of 4300 m by road. Blood samples were collected after 48 h stay at 3600 m and again after 48 h and 7 days of stay at 4300 m during 0700-0730 h. There was a decrease in energy intake (850 kcal/day) of sojourners, which resulted in loss of body weight by 2.12 kg at HA. At an altitude of 4300 m there was a significant increase in leptin over basal levels (54.9%, p < 0.001) at 48 h that persisted even after 7 days of stay at this altitude. Ghrelin levels of sojourners decreased by more than 30% in comparison to basal values at 48 h of ascent to HA. Leptin levels of acclimatized lowlanders were also higher in comparison with control group (acclimatized group 7.6 + 0.6 ng/ml vs. control 5.6 + 0.5 ng/ml, p < 0.01, n = 50).

Chronic carbon monoxide treatment attenuates development of obesity and remodels adipocytes in mice fed a high-fat diet

Objective

Induction of heme oxygenase-1 (HO-1) has been demonstrated to result in chronic weight loss in several rodent models of obesity. However, the specific contribution of the HO metabolite, carbon monoxide (CO) to this response remains unknown. In this study, we determined the effect of chronic low level administration of a specific CO donor on the progression of obesity and its effects on metabolism and adipocyte biology in mice fed a high fat diet.

Design

Experiments were performed on C57BL/6J mice fed a high (60%) fat diet from 4 weeks until 30 weeks of age. Mice were administered either the CO donor, CORM-A1 (5 mg/kg, ip every other day) or the inactive form of the drug (iCORM-A1). Body weights were measured weekly and fasted blood glucose, insulin as well as body composition were measured every 6 weeks. Food intake, O₂ consumption, CO₂ production, activity, and body heat production were measured at 28 weeks after start of the experimental protocol.

Results

Chronic CORM-A1 attenuated the development of high fat induced obesity from 18 weeks until the end of the study. Chronic CORM-A1 treatment in mice fed a high fat diet resulted in significant decreases in fasted blood glucose, insulin, and body fat and increased O₂ consumption, and heat production as compared to mice treated with iCORM-A1. Chronic CORM-A1 treatment also resulted in a significant decrease in adipocyte size and an increase in adipocyte number and in NRF1, PGC-1α, and UCP-1 protein levels in epidydmal fat.

Conclusion

Our results demonstrate that chronic CO treatment prevents the development of high fat diet induced obesity via stimulation of metabolism and remodeling of adipocytes.

Association of elevation, urbanization and ambient temperature with obesity prevalence in the United States

BACKGROUND

The macrogeographic distribution of obesity in the United States, including the association between elevation and body mass index (BMI), is largely unexplained. This study examines the relationship between obesity and elevation, ambient temperature and urbanization.

METHODS AND FINDINGS

Data from a cross-sectional, nationally representative sample of 422603 US adults containing BMI, behavioral (diet, physical activity, smoking) and demographic (age, sex, race/ethnicity, education, employment, income) variables from the 2011 Behavioral Risk Factor Surveillance System were merged with elevation and temperature data from WorldClim and with urbanization data from the US Department of Agriculture. There was an approximately parabolic relationship between mean annual temperature and obesity, with maximum prevalence in counties with average temperatures near 18 °C. Urbanization and obesity prevalence exhibited an inverse relationship (30.9% in rural or nonmetro counties, 29.2% in metro counties with <250000 people, 28.1% in counties with population from 250000 to 1 million and 26.2% in counties with >1 million). After controlling for urbanization, temperature category and behavioral and demographic factors, male and female Americans living <500 m above sea level had 5.1 (95% confidence interval (CI) 2.7-9.5) and 3.9 (95% CI 1.6-9.3) times the odds of obesity, respectively, as compared with counterparts living ≥ 3000 m above sea level.

CONCLUSIONS

Obesity prevalence in the United States is inversely associated with elevation and urbanization, after adjusting for temperature, diet, physical activity, smoking and demographic factors.

Chronic hypoxia exposure during pregnancy is associated with a decreased active nursing activity in mother and an abnormal birth weight and postnatal growth in offspring of rats

Stress during pregnancy is known to have a significant impact on animal's behavior and offspring development. The effects of gestational hypoxia on maternal behavior have not been studied. In the present study, we investigated the effects of gestational hypoxia exposure on dam's maternal behavior, offspring's growth and plasma corticosterone levels after parturition in rats. Altitude hypoxia (3 and 5 km) was simulated in the hypobaric chambers during the last week of pregnancy and the effects were compared to those found in controls exposed at sea level. We found that gestational hypoxia significantly decreased dam's arched-back nursing activity across the lactation period. The effect was more profound in 5 km group. Gestational hypoxia also altered other maternal behaviors such as blanket and passive nursing. Hypoxia exposure was associated with abnormal birth weight and postnatal growth in pups, with a significantly higher and lower birth weight than control found in 3 and 5 km groups, respectively, and accelerated growth in both stressed groups. Gestational hypoxia exposure significantly elevated plasma corticosterone levels in dams at the time of weaning and in pups across the measurement days. Taken together, the present results indicate that hypoxia, particularly severe hypoxia during the late phase of pregnancy has a significantly adverse impact on animal's behavior, endocrine function and offspring development. The higher birth weight found in the offspring of 3 km group suggests a compensatory system counteracting with the inhibitory effects of hypoxia on fetus growth at this altitude.

Obesity in Tibetans aged 30-70 living at different altitudes under the north and south faces of Mt. Everest

Risk factors for chronic diseases in Tibetans may be modified due to hypobaric hypoxia. The objectives of this study were to determine the prevalence of obesity at varying altitudes of 1,200, 2,900 and 3,700 meters above sea-level in Tibet and Nepal; to estimate the effect of altitude on body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). Three cross-sectional studies with simple random sampling were performed on 617 men and women. BMI, WC and WHtR decreased with increasing altitude. It is likely that the physical conditions such as low temperatures and low oxygen levels have a direct catabolic effect.

Effect of l-Carnitine Supplementation on Endurance Exercise in Normobaric/Normoxic and Hypobaric/Hypoxic Conditions

OBJECTIVE

To evaluate the effect of L-carnitine supplementation on improving endurance exercise in normobaric/normoxic and hypobaric/hypoxic environments.

METHODS

Six-week-endurance-trained male Sprague-Dawley rats (n = 24) were randomly divided into 2 groups: control and experimental; the latter group was supplemented with L-carnitine, administered orally in a dose of 100 mg x kg(-1) body weight. The animals were supplemented for 25 days under ambient normobaric/normoxic conditions and thereafter were exposed to 72 hours of hypobaric hypoxia equivalent to 6100 m. The supplementation was continued during the exposure. "Run to exhaustion" was recorded on day 1 (R1) (presupplementation) and on days 7 (R2), 14 (R3), 21 (R4), and 28 (R5, which followed the last 72 hours of hypoxic exposure) of supplementation. Food intake, body weight, and the biochemical measures of plasma glucose, total cholesterol, and high-density lipoprotein (HDL) cholesterol were recorded.

RESULTS

There was a significant improvement in endurance exercise, as indicated by an increase in run to exhaustion following L-carnitine supplementation under normobaric normoxia (36%-39%) and hypobaric hypoxia (50%). L-carnitine supplementation had no effect on plasma glucose levels either at sea level or after hypoxic exposure. Total cholesterol was decreased in normoxic and HDL cholesterol was increased in normoxic and hypoxic conditions, indicating a beneficial effect of exercise.

CONCLUSION

L-carnitine supplementation improved exercise endurance in rats exposed to normobaric normoxic and hypobaric hypoxic conditions. Such supplementation would be beneficial in delaying the onset of fatigue during prolonged exercise in both conditions, indicating its potentially beneficial use at high altitude.

Chronic hypoxia decreases endothelial nitric oxide synthase protein expression in fetal guinea pig hearts

OBJECTIVES

The underlying cellular mechanisms mediating hypoxia-induced adaptations in the fetus are poorly understood. We tested the hypothesis that hypoxia up-regulates endothelial nitric oxide synthase (NOS3, type III) protein expression in fetal hearts similar to that observed in adult hearts as a cardioprotective adaptation. This study investigates the effect of chronic hypoxia on NOS3 protein expression in hearts and carotid arteries of fetal guinea pigs exposed to normoxia or intrauterine hypoxia.

METHODS

Time-mated pregnant guinea pigs (term = 65 days) were housed in either normoxic room air (NMX) or exposed to 12% O(2) (hypoxia; HPX) for 14 or 28 days of duration. At near term ( approximately 60 days of gestation), pregnant mothers were anesthetized and fetal guinea pig hearts and carotid arteries were excised from NMX and HPX animals and frozen until ready for study. In addition, hearts were also excised from anesthetized adult nonpregnant female guinea pigs exposed to either NMX or HPX for 14 days. NOS3 protein was extracted from all tissues and quantified using Western blot analysis. Fetal heart samples were also prepared for localization of NOS3 protein using immunohistochemistry.

RESULTS

Chronic hypoxia increased both maternal and fetal hematocrit after 28 days of duration. HPX decreased NOS3 protein levels in fetal guinea pig hearts by 29% after 28 days compared to NMX controls. In contrast, HPX increased both NOS3 protein levels in adult hearts by 62% and fetal carotid arteries by fourfold after 14 days of exposure compared to their respective NMX controls. Positive immunostaining of NOS3 protein of fetal hearts was localized in both cardiomyocytes and endothelial cells.

CONCLUSION

Contrary to our hypothesis, the hypoxia-induced decrease in fetal guinea pig heart NOS3 protein contrasts to the protein levels measured in either adult hearts or fetal carotid arteries. These results suggest that the NOS protein expression is altered differently by hypoxia in fetal and adult hearts and in a peripheral fetal artery exposed to the same level of hypoxia. Thus, the functional role of NO in the fetal heart during hypoxia may differ from that of the adult.

Enhanced erythropoietin production during hypobaric hypoxia in mice under treatments to keep the erythrocyte mass from rising: implications for the adaptive role of polycythemia

Stress erythropoiesis is usually considered as a compensatory effort to counteract tissue hypoxia. Its homeostatic importance in anemic hypoxia has not been questioned, but researchers, clinicians, and mountain climbers have had second thoughts on polycythemia as to its appropriateness for hypoxic or altitude hypoxia (HA). Therefore, polycythemia, one of the responses to HA seen in nongenetically adapted mammals, could or could not be considered beneficial. The present study was thus performed to obtain further information on the importance of HA polycythemia on acclimation of mice to HA. To this end, the development of polycythemia was prevented by experimental manipulations (administration of 20 mg/kg/d of the hemolytic drug phenylhydrazine or removal of 0.225 mL/d of blood), and the degree of tissue hypoxia was evaluated from plasma erythropoietin (pEPO) concentration, as determined by immunoassay, in adult female mice exposed to air maintained at 506 mbar (380 mmHg) in a simulated HA (SHA) chamber during at least 23.5 h/d for 9 d. Plasma EPO concentration in those treated hypoxic mice whose hematocrit values remained almost unchanged was between 5.55 and 7.89 times higher (depending on the experimental designs) than in control hypoxic mice allowed to develop HA polycythemia. These results, plus the finding of an inverse relationship between the hematocrit value and pEPO concentration in both the polycythemic and normocythemic SHA-exposed mice indicate that HA polycythemia is highly effective in ameliorating tissue hypoxia under SHA conditions, thus giving support to the concept of the important role of the increased hemoglobin mass in nongenetically adapted animals, whereas a left-shifted oxyhemoglobin dissociation curve confers a good degree of adaptation to HA in genetically adapted animals.

Simulated high altitude selectively decreases protein intake and lean mass gain in rats

The aim of this study was to find out whether high altitude (HA)-induced hypophagia was macronutrient-specific using a self-selection procedure. Body composition was assessed by dual X-ray absorptiometry before and after exposure and by dissection at the end of the experiment. Energy intake, macronutrient selection, body composition, plasma insulin and leptin concentrations were measured in rats (FHx) exposed 16 h daily for 10 days to hypobaric hypoxia (HH) simulating an altitude of 5500 m. Rats were fasted during the exposure to HH and had access to food only during the 8 h of normoxia in their active period. This group was compared to control group (C) with ad libitum access to food and a group of rats submitted only to the 16-h fast (FNx). Results showed that sustained hypophagia was specific to protein (55 +/- 5% of C, P < .05), whereas after a decline, carbohydrate intake reached its basal level on the 5th day. HH dramatically reduced fat-free mass gain (P < .05 and P < .0001 compared to C and FNx, respectively). Plasma leptin concentrations at the onset of the period of access to food were not significantly different from those of controls. Across groups, leptin was positively correlated with fat mass (r = .71, P < .001) and negatively with energy intake (r = -.52, P < .05), more specifically with protein intake (r = -.57, P < .05). These results suggest that HA leads to a reduced preference for protein impairing fat-free mass gain and that leptin may contribute to this hypophagia.

Heart mitochondrial nitric oxide synthase is upregulated in male rats exposed to high altitude (4,340 m)

Male rats exposed for 21 days to high altitude (4,340 m) responded with arrest of weight gain and increased hematocrit and testosterone levels. High altitude significantly (58%) increased heart mitochondrial nitric oxide (NO) synthase (mtNOS) activity, whereas heart cytosolic endothelial NOS (eNOS) and liver mtNOS were not affected. Western blot analysis found heart mitochondria reacting only with anti-inducible NOS (iNOS) antibodies, whereas the postmitochondrial fraction reacted with anti-iNOS and anti-eNOS antibodies. In vitro-measured NOS activities allowed the estimation of cardiomyocyte capacity for NO production, a value that increased from 57% (sea level) to 79 nmol NO.min(-1).g heart(-1) (4,340 m). The contribution of mtNOS to total cell NO production increased from 62% (sea level) to 71% (4340 m). Heart mtNOS activity showed a linear relationship with hematocrit and a biphasic quadratic association with estradiol and testosterone. Multivariate analysis showed that exposure to high altitude linearly associates with hematocrit and heart mtNOS activity, and that testosterone-to-estradiol ratio and heart weight were not linearly associated with mtNOS activity. We conclude that high altitude triggers a physiological adaptive response that upregulates heart mtNOS activity and is associated in an opposed manner with the serum levels of testosterone and estradiol.