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肥胖是急性高原病的一个危险因素:一项针对青藏高原铁路建设工人的前瞻性研究。

Obesity is a risk factor for acute mountain sickness: a prospective study in Tibet railway construction workers on Tibetan plateau.

作者信息

Yang B, Sun Z-J, Cao F, Zhao H, Li C-W, Zhang J

机构信息

Cardiovascular Department, Chinese PLA General Hospital, Beijing, China.

出版信息

Eur Rev Med Pharmacol Sci. 2015 Jan;19(1):119-22.

PMID:25635984
Abstract

OBJECTIVE

Although few retrospective studies of high altitude have reported that obesity might be associated with the development of acute mountain sickness (AMS), this association has not been fully studied prospectively. The aim of this study was to investigate the effect of obesity on subjects with acute high-altitude exposure.

PATIENTS AND METHODS

Totally 262 male subjects aged 25-43 (mean 33.2 ± 9.3) years with acute high-altitude exposure were involved in this study. Among them, there are 120 obese and 142 non-obese young-middle aged male subjects. Each subject completed an AMS (acute mountain sickness) self-report questionnaire at sea level and after ascending high-altitude (3658 meters) 12 hours and 24 hours. Weight and height were measured and BMI was calculated. Vital capacity of lungs was measured. Venous blood was sampled for measuring hemoglobin at baseline. Arterial blood was taken for evaluating arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude.

RESULTS

No statistical differences were found between groups at age (p = 0.1488), hemoglobin (p = 0.5807) and vital capacity (p = 0.1806). BMI in the two groups was significantly different (p < 0.001) because it is the cut-off point of grouping. At sea level, no statistical differences were found between groups at SO2 (p = 0.1806), PaO2 (p = 0.0949), PaCO2 (p = 0.1960). But 24 hours after ascending high-altitude, SO2 (p = 0.0002), PaO2 (p < 0.001) were much lower and PaCO2 (p < 0.001) was significantly higher in obese group than in non-obese group. Comparison of AMS score: No symptom was reported at sea level in all participants (scored 0). But 12-hour and 24-hour after ascending high-altitude, the AMS scores in obese group were significantly higher than those in non-obese group (p < 0.001).

CONCLUSIONS

Obesity is an important risk factor in the development of acute mountain sickness.

摘要

目的

尽管少数关于高海拔的回顾性研究报告称肥胖可能与急性高原病(AMS)的发生有关,但这种关联尚未得到充分的前瞻性研究。本研究的目的是调查肥胖对急性高海拔暴露受试者的影响。

患者与方法

本研究共纳入262名年龄在25 - 43岁(平均33.2±9.3岁)的急性高海拔暴露男性受试者。其中,有120名肥胖的中青年男性受试者和142名非肥胖的中青年男性受试者。每位受试者在海平面、海拔上升后12小时和24小时(海拔3658米)完成一份急性高原病(AMS)自我报告问卷。测量体重和身高并计算体重指数(BMI)。测量肺活量。在基线时采集静脉血用于测量血红蛋白。在基线和海拔上升24小时后采集动脉血用于评估动脉血氧饱和度(SO2)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)。

结果

两组在年龄(p = 0.1488)、血红蛋白(p = 0.5807)和肺活量(p = 0.1806)方面无统计学差异。两组的BMI存在显著差异(p < 0.001),因为它是分组的切点。在海平面时,两组在SO2(p = 0.1806)、PaO2(p = 0.0949)、PaCO2(p = 0.1960)方面无统计学差异。但在海拔上升24小时后,肥胖组的SO2(p = 0.0002)、PaO2(p < 0.001)明显低于非肥胖组,而PaCO2(p < 0.001)明显高于非肥胖组。急性高原病评分比较:所有参与者在海平面时均无症状报告(评分为0)。但在海拔上升12小时和24小时后,肥胖组的急性高原病评分明显高于非肥胖组(p < 0.001)。

结论

肥胖是急性高原病发生的一个重要危险因素。

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