Unidad de Investigación del Hospital Universitario, Nuestra Señora de Candelaria y de Atención Primaria, Tenerife, Spain.
High Alt Med Biol. 2011 Summer;12(2):179-86. doi: 10.1089/ham.2010.1078.
Despite the higher prevalence of diabetes and hypertension in populations residing at moderate altitudes, mortality in these populations is lower than in populations residing at low altitudes. To examine whether metabolic and hemodynamic differences can explain this apparent paradox, we performed a cross-sectional study of a general population sample recruited in the Canary Islands, Spain (n=6729). We recorded altitude of residence, age, heart rate, blood pressure, body mass index, social class, physical activity, energy intake, alcohol intake, smoking habit, prevalence of type 2 diabetes mellitus and hypertension. In a subsample (n=903), we recorded serum concentration of cholesterol, triglycerides, glucose, C peptide, leptin, soluble leptin receptor (sObR), C-reactive protein, resistin, soluble CD40 ligand (sCD40L), and paraoxonase activity (PON), and we estimated insulin resistance and free leptin index. We found an inverse association between altitude and heart rate (p<0.001), leptin (p<0.001), free leptin index (p<0.001), resistin (p<0.001), and sCD40L (p<0.05) and a direct association between altitude and hypertension (odds ratio=1.29 for altitude >600 m; 95% confidence interval=1.03-1.62), glycemia (p<0.05), C peptide (p<0.001), insulin resistance (p<0.001), sObR (p<0.05), and PON (p<0.05). When social class was included in the multivariate model, the association with PON was no longer significant. In conclusion, individuals residing at moderate altitudes have a lower heart rate and lower serum concentration of total leptin, free leptin, and sCD40L. These differences may partially explain the lower mortality in these populations.
尽管居住在中海拔地区的人群中糖尿病和高血压的患病率较高，但这些人群的死亡率低于低海拔地区的人群。为了研究代谢和血液动力学差异是否可以解释这一明显的悖论，我们对西班牙加那利群岛的一个普通人群样本进行了横断面研究（n=6729）。我们记录了居住地的海拔高度、年龄、心率、血压、体重指数、社会阶层、体力活动、能量摄入、酒精摄入、吸烟习惯、2 型糖尿病和高血压的患病率。在一个亚样本（n=903）中，我们记录了血清胆固醇、甘油三酯、葡萄糖、C 肽、瘦素、可溶性瘦素受体（sObR）、C 反应蛋白、抵抗素、可溶性 CD40 配体（sCD40L）和对氧磷酶活性（PON）的浓度，并估计了胰岛素抵抗和游离瘦素指数。我们发现海拔高度与心率（p<0.001）、瘦素（p<0.001）、游离瘦素指数（p<0.001）、抵抗素（p<0.001）和 sCD40L（p<0.05）呈负相关，与高血压（比值比=1.29，海拔高度>600 米；95%置信区间=1.03-1.62）、血糖（p<0.05）、C 肽（p<0.001）、胰岛素抵抗（p<0.001）、sObR（p<0.05）和 PON（p<0.05）呈正相关。当将社会阶层纳入多变量模型时，与 PON 的关联不再显著。总之，居住在中海拔地区的个体心率较低，血清总瘦素、游离瘦素和 sCD40L 浓度较低。这些差异可能部分解释了这些人群死亡率较低的原因。
