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Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

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dc.contributor.author Miele, Catherine H.
dc.contributor.author Schwartz, Alan R.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Pham, Luu
dc.contributor.author Wise, Robert A.
dc.contributor.author Davila-Roman, Victor G.
dc.contributor.author Jun, Jonathan C.
dc.contributor.author Polotsky, Vsevolod Y.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author León-Velarde, Fabiola
dc.contributor.author Checkley, William
dc.date.accessioned 2019-02-06T14:45:56Z
dc.date.available 2019-02-06T14:45:56Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5122
dc.description.abstract Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93-100, 2016.-Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated with cardiovascular complications, it is unclear how worsening hypoxemia of any degree affects cardiometabolic risk factors in high-altitude populations. We studied the relationship between daytime resting oxyhemoglobin saturation and cardiometabolic risk factors in adult participants living in Puno, Peru (3825 m above sea level). We used multivariable logistic regression models to study the relationship between having a lower oxyhemoglobin saturation and markers of cardiometabolic risk. Nine hundred and fifty-four participants (mean age 55 years, 52% male) had information available on pulse oximetry and markers of cardiometabolic risk. Average oxyhemoglobin saturation was 90% (interquartile range 88%-92%) and 43 (4.5%) had excessive erythrocytosis. Older age, decreased height-adjusted lung function, and higher body mass index (BMI) were associated with having an oxyhemoglobin saturation </=85%. When adjusting for age, sex, socioeconomic status, having excessive erythrocytosis, and site, we found that each 5% decrease in oxyhemoglobin saturation was associated with a higher adjusted odds of metabolic syndrome (OR = 1.35, 95% CI: 1.07-1.72, p < 0.04), insulin resistance as defined by homeostasis model assessment-insulin resistance (HOMA-IR) >2 mass units (OR = 1.29, 95% CI: 1.00-1.67, p < 0.05), hemoglobin A1c >/=6.5% (OR = 1.66, 95% CI: 1.09-2.51, p < 0.04), and high sensitivity C-reactive protein (hs-CRP) >/=3 mg/L (OR = 1.46, 95% CI: 1.09-1.96, p < 0.01). In high-altitude populations in Puno, Peru, a higher BMI and lower pulmonary function were associated with lower resting daytime oxyhemoglobin saturation. Lower resting oxyhemoglobin saturation, in turn, was associated with higher odds of having multiple unfavorable cardiometabolic factors. Worsening hypoxia of any degree in high-altitude dwellers may be an independent risk factor for cardiovascular disease. en_US
dc.language.iso eng
dc.publisher Mary Ann Liebert
dc.relation.ispartofseries High Altitude Medicine and Biology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Altitude en_US
dc.subject Disease Progression en_US
dc.subject Adult en_US
dc.subject altitude en_US
dc.subject Biomarkers/blood en_US
dc.subject Body Mass Index en_US
dc.subject C-Reactive Protein/analysis en_US
dc.subject Cardiovascular Diseases/etiology en_US
dc.subject diabetes en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject hypoxemia en_US
dc.subject Hypoxia/blood/complications/physiopathology en_US
dc.subject insulin resistance en_US
dc.subject Insulin Resistance en_US
dc.subject Logistic Models en_US
dc.subject Male en_US
dc.subject metabolic syndrome en_US
dc.subject Metabolic Syndrome/etiology en_US
dc.subject Middle Aged en_US
dc.subject Oximetry en_US
dc.subject Oxyhemoglobins/analysis en_US
dc.subject Peru en_US
dc.subject Polycythemia/blood/complications en_US
dc.subject Rest/physiology en_US
dc.subject Risk Factors en_US
dc.title Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1089/ham.2015.0084
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.11
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 1557-8682


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