Aryal Nirmal, Weatherall Mark, Bhatta Yadav Kumar Deo, Mann Stewart
Department of Medicine, University of Otago, Wellington 6021, New Zealand.
Norvic International Hospital, Kathmandu 14126, Nepal.
Int J Environ Res Public Health. 2017 Sep 10;14(9):1041. doi: 10.3390/ijerph14091041.
This study aimed to describe lipid profiles and the distribution of glycated hemoglobin (HbA1c) in a sample of a high altitude population of Nepal and to explore associations between these metabolic risk variables and altitude. A cross-sectional survey of cardiovascular disease and associated risk factors was conducted among 521 people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. Urban participants (residents at 2800 m and 3620 m) had higher total cholesterol (TC) and triglyceride (TG) than rural participants. A high ratio of TC to high-density lipoprotein-cholesterol (HDL) (TC/HDL ≥ 5.0) was found in 23.7% (95% CI 19.6, 28.2) and high TG (≥1.7 mmol/L) in 43.3% (95% CI 38.4, 48.3) of participants overall. Mean HbA1c levels were similar at all altitude levels although urban participants had a higher prevalence of diabetes. Overall, 6.9% (95% CI 4.7, 9.8) of participants had diabetes or were on hypoglycaemic treatment. There was no clear association between lipid profiles or HbA1c and altitude in a multivariate analysis adjusted for possible confounding variables. Residential settings and associated lifestyle practices are more strongly associated with lipid profiles and HbA1c than altitude amongst high altitude residents in Nepal.
本研究旨在描述尼泊尔高海拔人群样本中的血脂谱和糖化血红蛋白（HbA1c）分布情况，并探讨这些代谢风险变量与海拔之间的关联。在尼泊尔木斯塘和胡姆拉地区，对生活在四个不同海拔高度（均高于2800米）的521人进行了心血管疾病及相关危险因素的横断面调查。城市参与者（居住在2800米和3620米处）的总胆固醇（TC）和甘油三酯（TG）水平高于农村参与者。总体而言，23.7%（95%可信区间19.6, 28.2）的参与者总胆固醇与高密度脂蛋白胆固醇（HDL）之比（TC/HDL≥5.0）较高，43.3%（95%可信区间38.4, 48.3）的参与者甘油三酯水平较高（≥1.7 mmol/L）。尽管城市参与者糖尿病患病率较高，但所有海拔水平的平均HbA1c水平相似。总体而言，6.9%（95%可信区间4.7, 9.8）的参与者患有糖尿病或正在接受降糖治疗。在对可能的混杂变量进行调整的多变量分析中，血脂谱或HbA1c与海拔之间没有明显关联。在尼泊尔高海拔居民中，居住环境及相关生活方式与血脂谱和HbA1c的关联比海拔更为密切。
