Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

León-Velarde, Fabiola; Gilman, Robert Hugh; Wise, Robert A.; Miele, Catherine H.; Miranda, J. Jaime; Pham, Luu; Jun, Jonathan C.; Checkley, William; Polotsky, Vsevolod Y.; Davila-Roman, Victor G.; Schwartz, Alan R.

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