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Horiuchi M, Mitsui S, Uno T. Influence of Smoking and Alcohol Habits on Symptoms of Acute Mountain Sickness on Mount Fuji: A Questionnaire Survey-Based Pilot Study. High Alt Med Biol 2024; 25:140-148. [PMID: 38416507 DOI: 10.1089/ham.2023.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Horiuchi, Masahiro, Satomi Mitsui, and Tadashi Uno. Influence of smoking and alcohol habits on symptoms of acute mountain sickness on Mount Fuji: a questionnaire survey-based pilot study. High Alt Med Biol 00:000-000, 2024. Background: Acute cigarette smoking or alcohol intake would cause opposing vasculature effects that may influence acute mountain sickness (AMS). The present study aimed to investigate the effects of smoking and alcohol consumption behaviors, and acute smoking and consuming alcohol during ascent on AMS on Mount Fuji. Methods: This questionnaire survey study included 887 participants who climbed Mount Fuji and obtained information regarding sex, age, and smoking and alcohol habits, including behavior during ascent. Results: AMS prevalence was 45% for all participants. A univariate analysis revealed that younger participants (20-29 years) were associated with increased AMS prevalence (effect size [ES] = 0.102, p = 0.057) and severity (ES = 0.18, p = 0.01). A prediction model using multiple logistic regression indicated that several factors influenced AMS risk: younger age (p = 0.001), daily smoking habits (p = 0.021), no smoking (p = 0.033), or alcohol consumption during ascent (p = 0.096). Alcohol consumption during ascent had no effect on the increased AMS risk in younger participants (20-29 years), while alcohol consumption during ascent increased AMS risk for middle-age participants (50-59 years). Conclusion: Younger individuals are more likely to experience AMS. Smoking habits are associated with an increased AMS risk. It may be recommended that middle-aged climbers should ascend without consuming alcohol.
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Affiliation(s)
- Masahiro Horiuchi
- Faculty of Sports and Life Science, National Institute of Fitness and Sports in KANOYA, Kanoya-City, Japan
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
| | - Satomi Mitsui
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
| | - Tadashi Uno
- Division of Human Environmental Science, Mount Fuji Research Institute, Fujiyoshida City, Japan
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Modenini G, Abondio P, Sazzini M, Boattini A. Polymorphic transposable elements provide new insights on high-altitude adaptation in the Tibetan Plateau. Genomics 2024; 116:110854. [PMID: 38701989 DOI: 10.1016/j.ygeno.2024.110854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/23/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
Several studies demonstrated that populations living in the Tibetan plateau are genetically and physiologically adapted to high-altitude conditions, showing genomic signatures ascribable to the action of natural selection. However, so far most of them relied solely on inferences drawn from the analysis of coding variants and point mutations. To fill this gap, we focused on the possible role of polymorphic transposable elements in influencing the adaptation of Tibetan and Sherpa highlanders. To do so, we compared high-altitude and middle/low-lander individuals of East Asian ancestry by performing in silico analyses and differentiation tests on 118 modern and ancient samples. We detected several transposable elements associated with high altitude, which map genes involved in cardiovascular, hematological, chem-dependent and respiratory conditions, suggesting that metabolic and signaling pathways taking part in these functions are disproportionately impacted by the effect of environmental stressors in high-altitude individuals. To our knowledge, our study is the first hinting to a possible role of transposable elements in the adaptation of Tibetan and Sherpa highlanders.
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Affiliation(s)
- Giorgia Modenini
- Dept. of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy.
| | - Paolo Abondio
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - Marco Sazzini
- Dept. of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy; Interdepartmental Centre - Alma Mater Research Institute on Global Changes and Climate Change, University of Bologna, Italy
| | - Alessio Boattini
- Dept. of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy
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Fabries P, Gomez-Merino D, Sauvet F, Malgoyre A, Koulmann N, Chennaoui M. Sleep loss effects on physiological and cognitive responses to systemic environmental hypoxia. Front Physiol 2022; 13:1046166. [PMID: 36579023 PMCID: PMC9792101 DOI: 10.3389/fphys.2022.1046166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
In the course of their missions or training, alpinists, but also mountain combat forces and mountain security services, professional miners, aircrew, aircraft and glider pilots and helicopter crews are regularly exposed to altitude without oxygen supplementation. At altitude, humans are exposed to systemic environmental hypoxia induced by the decrease in barometric pressure (<1,013 hPa) which decreases the inspired partial pressure of oxygen (PIO2), while the oxygen fraction is constant (equal to approximately 20.9%). Effects of altitude on humans occur gradually and depend on the duration of exposure and the altitude level. From 1,500 m altitude (response threshold), several adaptive responses offset the effects of hypoxia, involving the respiratory and the cardiovascular systems, and the oxygen transport capacity of the blood. Fatigue and cognitive and sensory disorders are usually observed from 2,500 m (threshold of prolonged hypoxia). Above 3,500 m (the threshold for disorders), the effects are not completely compensated and maladaptive responses occur and individuals develop altitude headache or acute altitude illness [Acute Mountain Sickness (AMS)]. The magnitude of effects varies considerably between different physiological systems and exhibits significant inter-individual variability. In addition to comorbidities, the factors of vulnerability are still little known. They can be constitutive (genetic) or circumstantial (sleep deprivation, fatigue, speed of ascent.). In particular, sleep loss, a condition that is often encountered in real-life settings, could have an impact on the physiological and cognitive responses to hypoxia. In this review, we report the current state of knowledge on the impact of sleep loss on responses to environmental hypoxia in humans, with the aim of identifying possible consequences for AMS risk and cognition, as well as the value of behavioral and non-pharmacological countermeasures.
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Affiliation(s)
- Pierre Fabries
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,*Correspondence: Pierre Fabries,
| | - Danielle Gomez-Merino
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Fabien Sauvet
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
| | - Alexandra Malgoyre
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France
| | - Nathalie Koulmann
- Laboratoire de Biologie de l’Exercice pour la Performance et la Santé (LBEPS), UMR, Université Paris-Saclay, IRBA, Evry-Courcouronnes, France,French Military Health Academy—Ecole du Val-de-Grâce, Place Alphonse Laveran, Paris, France
| | - Mounir Chennaoui
- REF-Aero Department, French Armed Forces Biomedical Research Institute—IRBA, Brétigny-sur-Orge, France,Vigilance Fatigue Sommeil et Santé Publique (VIFASOM) URP 7330, Université de Paris Cité, Paris, France
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Chen R, Sun M, Yang J, Liu C, Zhang J, Ke J, Deng Y, He C, Yang Y, Cheng R, Yuan F, Tan H, Gao X, Huang L. Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study. Front Physiol 2021; 12:708862. [PMID: 34512383 PMCID: PMC8430240 DOI: 10.3389/fphys.2021.708862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/31/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Acute high-altitude (HA) exposure results in blood pressure (BP) and cardiac function variations in most subjects, some of whom suffer from acute mountain sickness (AMS). Several previous studies have found that cardiovascular function indicators are potentially correlated with AMS. Objectives: This study aims to examine HA-induced cardiovascular adaptations in AMS patients and compare them with healthy subjects. It also aims to investigate the relationship between cardiovascular function indicators and AMS, as well as to provide some insightful information about the prevention and treatment of AMS. Methods: Seventy-two subjects were enrolled in this cohort study. All the subjects ascended Litang (4,100 m above sea level). They were monitored by a 24-h ambulatory blood pressure (ABP) device and underwent echocardiography examination within 24 h of altitude exposure. The 2018 Lake Louise questionnaire was used to evaluate AMS. Results: Acute mountain sickness group consisted of more women (17 [60.7%] vs. 10 [22.7%], p = 0.001) and fewer smokers (5 [17.9%] vs. 23 [52.3%], p = 0.003). Compared with subjects without AMS, subjects with AMS had lower pulse pressure (PP) (daytime PP, 45.23 ± 7.88 vs. 52.14 ± 4.75, p < 0.001; nighttime PP, 42.81 ± 5.92 vs. 49.39 ± 7.67, p < 0.001) and lower effective arterial elastance (Ea) (1.53 ± 0.24 vs. 1.73 ± 0.39, p = 0.023). Multivariate regression indicated that female sex (OR = 0.23, p = 0.024), lower daytime PP (OR = 0.86, p = 0.004), and lower Ea (OR = 0.03, p = 0.015) at low altitude (LA) were independent risk factors for AMS. Combined daytime PP and Ea at LA had a high predictive value for AMS (AUC = 0.873; 95% CI: 0.789–0.956). Correlation analysis showed that AMS-induced headache correlated with daytime PP (R = −0.401, p < 0.001) and nighttime PP at LA (R = −0.401, p < 0.001). Conclusion: Our study demonstrated that AMS patients had a lower PP and Ea at LA. These baseline indicators of vasodilation at LA were closely associated with AMS, which may explain the higher headache severity in subjects with higher PP at LA.
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Affiliation(s)
- Renzheng Chen
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Mengjia Sun
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jie Yang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuan Liu
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jihang Zhang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jingbin Ke
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuhan Deng
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chunyan He
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuanqi Yang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ran Cheng
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fangzhengyuan Yuan
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hu Tan
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xubin Gao
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Lan Huang
- Institute of Cardiovascular Diseases of Chinese People's Liberation Army, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Yu J, Liu C, Zhang C, Bian S, Yang J, Zhang J, Gao X, Qiu Y, Huang L. EDN1 gene potentially involved in the development of acute mountain sickness. Sci Rep 2020; 10:5414. [PMID: 32214168 PMCID: PMC7096518 DOI: 10.1038/s41598-020-62379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/09/2020] [Indexed: 11/09/2022] Open
Abstract
Previous investigations have indicated that environmental and genetic factors collectively contribute to the development of acute mountain sickness (AMS), but whether the EDN1 gene is involved in AMS remains to be elucidated. A total of 356 healthy male soldiers who had not traveled to high altitudes in the previous 12 months were enrolled in our study. All participants were taken by plane from 500 m (Chengdu in Sichuan Province) to a 3700 m highland (Lhasa) within 2 hours. Clinical data were collected within 24 hours, and pulmonary function parameters were completed simultaneously. Genotypes were obtained by using iMLDR genotyping assays. A total of 237 soldiers (66.57%) presented AMS symptoms, including headache, dizziness, gastrointestinal upset and fatigue. Soldiers with AMS showed an increase in heart rate (HR), plasma tryptophan and serotonin, and a decrease in SaO2, FEV1, PEF, FVC, V75, V50, V25 and MMF (all P < 0.01). Notably, allele T in single nucleotide polymorphism (SNP) rs2070699 showed a positive correlation with the occurrence of AMS. A general linear regression analysis showed that rs2060799, Mean Arterial Pressure (MAP), SaO2, FVC, tryptophan and serotonin were independent predictors for the occurrence of AMS. Importantly, the area under the curve (AUC) values for tryptophan (0.998), serotonin (0.912) and FVC (0.86) had diagnostic specificity and sensitivity. Our results demonstrated that AMS is accompanied by changes in lung function parameters, increased plasma tryptophan and serotonin levels, and that the EDN1 polymorphism is a potential risk factor for AMS.
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Affiliation(s)
- Jie Yu
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - Chuan Liu
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - Chen Zhang
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - ShiZhu Bian
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - Jie Yang
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - JiHang Zhang
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - XuBin Gao
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - YouZhu Qiu
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China
| | - Lan Huang
- Institute of Cardiovascular Diseases, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China. .,Department of Cardiology, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, China.
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Vinnikov D, Nenna R, Soumagne T. Will an electronic nose help at high altitude? Breathe (Sheff) 2018; 14:322-324. [PMID: 30519300 PMCID: PMC6269179 DOI: 10.1183/20734735.019918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An electronic nose does not simply detect the concentrations of selected VOCs in the exhaled air, but verifies the cumulative signature, reflecting the overall VOC concentration. This technology is novel but promising. http://ow.ly/IPCt30mbIBV.
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Affiliation(s)
- Denis Vinnikov
- School of Public Health, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Raffaella Nenna
- Dept of Paediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Thibaud Soumagne
- Dept of Respiratory Medicine, University Hospital, Besançon, France.,Dept of Physiology, University Hospital, Besançon, France
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Wu Y, Zhang C, Chen Y, Luo YJ. Association between acute mountain sickness (AMS) and age: a meta-analysis. Mil Med Res 2018; 5:14. [PMID: 29747689 PMCID: PMC5946480 DOI: 10.1186/s40779-018-0161-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 04/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute mountain sickness (AMS) is a potentially lethal condition caused by acute hypoxia after ascending to altitudes higher than 2500 m in a short time. The main symptom of AMS is headache. Numerous risk factors of AMS have been examined, including gender, obesity, ascent rate, age and individual susceptibility. In previous studies, age was considered a predisposing factor for AMS. However, different opinions have been raised in recent years. To clarify the association between AMS and age, we conducted this meta-analysis. METHODS We obtained observational studies that explored risk factors for AMS by searching PubMed, Embase, China National Knowledge Internet (CNKI), the Wanfang database and CQVIP for articles published before March 2017. The studies included were required to provide the mean age and its standard deviation for subjects with and without AMS, the maximum altitude attained and the mode of ascent. The Lake Louse Score (LLS) or the Chinese AMS score (CAS) was used to judge the severity of AMS symptoms and incidence. Studies were pooled for the analysis by using a random effects model in RevMan 5.0. Meta-regression and subgroup analyses were conducted to identify sources of heterogeneity using Stata 14.2 and RevMan 5.0. RESULTS In total, 17 studies were included, and the overall number of subjects with and without AMS was 1810 and 3014, respectively. The age ranged from 10 to 76 years. Analysis of the 17 included studies showed that age was not associated with AMS (mean difference (MD) = 0.10; 95% CI: -0.38-0.58; P = 0.69). CONCLUSION This meta-analysis suggests that there is no association between age and the risk of AMS. Race, age, and ascent mode are common sources of heterogeneity, which may provide an analytical orientation for future heterogeneity analyses.
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Affiliation(s)
- Yu Wu
- Department of Military Medical Geography, Army Medical Service Training Base, Army Medical University, Chongqing, 400038, China.,Battalion 5 of Cadet Brigade, Army Medical University, Chongqing, 400038, China
| | - Chi Zhang
- Department of Military Medical Geography, Army Medical Service Training Base, Army Medical University, Chongqing, 400038, China.,Key Laboratory of High Altitude Environmental Medicine of PLA, Army Medical University, Chongqing, 400038, China
| | - Yu Chen
- Department of Military Medical Geography, Army Medical Service Training Base, Army Medical University, Chongqing, 400038, China.,Key Laboratory of High Altitude Environmental Medicine of PLA, Army Medical University, Chongqing, 400038, China
| | - Yong-Jun Luo
- Department of Military Medical Geography, Army Medical Service Training Base, Army Medical University, Chongqing, 400038, China. .,Key Laboratory of High Altitude Environmental Medicine of PLA, Army Medical University, Chongqing, 400038, China.
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Relationship between Smoking and Acute Mountain Sickness: A Meta-Analysis of Observational Studies. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1409656. [PMID: 29259975 PMCID: PMC5702408 DOI: 10.1155/2017/1409656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/12/2017] [Accepted: 06/06/2017] [Indexed: 12/27/2022]
Abstract
Aims Previous epidemiological investigations of the relationship between smoking and acute mountain sickness (AMS) risk yielded inconsistent findings. Therefore, a meta-analysis of observational studies was performed to determine whether smoking is related to the development of AMS. Methods Searches were performed on PubMed, Scopus, Embase, and Web of Science for relevant studies that were published before November 2016 reporting smoking prevalence and AMS. Two evaluators independently selected studies, extracted data, and assessed study quality. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were obtained using random-effects models. Subgroup analyses were performed according to the type of participant, altitude, and study design. Results A total of 11 observational studies involving 7,106 participants, 2,408 of which had AMS, were eligible for inclusion in this meta-analysis. The summary RR for AMS comparing smokers to nonsmokers was 1.02 (95% CI: 0.83 to 1.26). Specific analyses for altitude, type of participant, and study design yielded similar results. There was significant heterogeneity for all studies (Q = 37.43; P < 0.001; I2 = 73%, 95% CI: 51% to 85%). No publication bias was observed (Egger's test: P = 0.548, Begg's test: P = 0.418). Conclusions The meta-analysis indicates that no difference was found in AMS risk with regard to smoking status.
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Sánchez-Mascuñano A, Masuet-Aumatell C, Morchón-Ramos S, Ramon JM. Relationship of altitude mountain sickness and smoking: a Catalan traveller's cohort study. BMJ Open 2017; 7:e017058. [PMID: 28947454 PMCID: PMC5623483 DOI: 10.1136/bmjopen-2017-017058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher. SETTING Travel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain. PARTICIPANTS A total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status. OUTCOMES The main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria. RESULTS AMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached. CONCLUSIONS These results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.
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Affiliation(s)
- Alba Sánchez-Mascuñano
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Cristina Masuet-Aumatell
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Sergio Morchón-Ramos
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
| | - Josep M Ramon
- Department of Preventive Medicine, Bellvitge Biomedical Research Institute (IDIBELL), International Health Center and Travel Medicine Clinic, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Catalonia, Spain
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Sightings, edited by Erik R. Swenson and Peter Bärtsch. High Alt Med Biol 2016. [DOI: 10.1089/ham.2016.29009.stg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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11
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Xu C, Lu HX, Wang YX, Chen Y, Yang SH, Luo YJ. Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies. Mil Med Res 2016; 3:37. [PMID: 27980800 PMCID: PMC5146861 DOI: 10.1186/s40779-016-0108-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 11/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People rapidly ascending to high altitudes (>2500 m) may suffer from acute mountain sickness (AMS). The association between smoking and AMS risk remains unclear. Therefore, we performed a meta-analysis to evaluate the association between smoking and AMS risk. METHODS The association between smoking and AMS risk was determined according to predefined criteria established by our team. Meta-analysis was conducted according to the PRISMA guidelines. We included all relevant studies listed in the PubMed and Embase databases as of September 2015 in this meta-analysis and performed systemic searches using the terms "smoking", "acute mountain sickness" and "risk factor". The included studies were required to provide clear explanations regarding their definitions of smoking, the final altitudes reached by their participants and the diagnostic criteria used to diagnose AMS. Odds ratios (ORs) were used to evaluate the association between smoking and AMS risk across the studies, and the Q statistic was used to test OR heterogeneity, which was considered significant when P < 0.05. We also computed 95% confidence intervals (CIs). Data extracted from the articles were analyzed with Review Manager 5.3 (Cochrane Collaboration, Oxford, UK). RESULTS We used seven case-control studies including 694 smoking patients and 1986 non-smoking controls to analyze the association between smoking and AMS risk. We observed a significant association between AMS and smoking (OR = 0.71, 95% CI 0.52-0.96, P = 0.03). CONCLUSIONS We determined that smoking may protect against AMS development. However, we do not advise smoking to prevent AMS. More studies are necessary to confirm the role of smoking in AMS risk.
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Affiliation(s)
- Chen Xu
- Department of Military Medical Geography, Third Military Medical University, Chongqing, 400038 China ; Battalion 5 of Cadet Brigade, Third Military Medical University, Chongqing, 400038 China ; Key Laboratory of High Altitude Environmental Medicine (Ministry of Education), Third Military Medical University, Chongqing, 400038 China
| | - Hong-Xiang Lu
- Department of Military Medical Geography, Third Military Medical University, Chongqing, 400038 China ; Key Laboratory of High Altitude Environmental Medicine (Ministry of Education), Third Military Medical University, Chongqing, 400038 China
| | - Yu-Xiao Wang
- Department of Military Medical Geography, Third Military Medical University, Chongqing, 400038 China ; Key Laboratory of High Altitude Environmental Medicine (Ministry of Education), Third Military Medical University, Chongqing, 400038 China
| | - Yu Chen
- Department of Military Medical Geography, Third Military Medical University, Chongqing, 400038 China ; Key Laboratory of High Altitude Environmental Medicine (Ministry of Education), Third Military Medical University, Chongqing, 400038 China
| | - Sheng-Hong Yang
- Mountain Sickness Research Institute, 18th Hospital of PLA, Yecheng, Xinjiang 844900 China
| | - Yong-Jun Luo
- Department of Military Medical Geography, Third Military Medical University, Chongqing, 400038 China ; Key Laboratory of High Altitude Environmental Medicine (Ministry of Education), Third Military Medical University, Chongqing, 400038 China
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