Prevalence, clinical profile, iron status, and subject-specific traits for excessive erythrocytosis in andean adults living permanently at 3,825 meters above sea level
- CRONICAS Cohort Study Group,
- Aldo De Ferrari(Author),
- J. Jaime Miranda(Author),
- Robert H. Gilman(Author),
- Victor G. Dávila-Román(Author),
- Fabiola León-Velarde(Author)
- Johns Hopkins University School of Medicine,
- Universidad Peruana Cayetano Heredia,
- Universidad Peruana Cayetano Heredia,
- Johns Hopkins University,
- Washington University in Saint Louis
Open access
Publication Information
Output type
Original language
EnglishPages from-to (Number of pages)
Pages 1327-1336 (10 pages)Journal (Volume, Issue Number)
Chest (Volume 146, Issue 5)Publication milestones
- Published - 01/11/2014
Publication status
ISSN
0012-3692Publication IDs
- Scopus: 84910011165
- PubMed: 24874587
Abstract
BACKGROUND: Excessive erythrocytosis (EE) is a prevalent condition in populations living at high altitudes (> 2,500 m above sea level). Few large population-based studies have explored the association between EE and multiple subject-specific traits including oxygen saturation, iron status indicators, and pulmonary function. METHODS: We enrolled a sex-stratified and age-stratified sample of 1,065 high-altitude residents aged ≥ 35 years from Puno, Peru (3,825 m above sea level) and conducted a standardized questionnaire and physical examination that included spirometry, pulse oximetry, and a blood sample for multiple clinical markers. Our primary objectives were to estimate the prevalence of EE, characterize the clinical profile and iron status indicators of subjects with EE, and describe subject-specific traits associated with EE. RESULTS: Overall prevalence of EE was 4.5% (95% CI, 3.3%-6.0%). Oxygen saturation was significantly lower among EE than non-EE group subjects (85.3% vs 90.1%, P,.001) but no difference was found in iron status indicators between both groups (P.>09 for all values). In multivariable logistic regression, we found that age ≥ 65 years (OR = 2.45, 95% CI, 1.16-5.09), male sex (3.86, 1.78-9.08), having metabolic syndrome (2.66, 1.27-5.75) or being overweight (5.20, 1.95-16.77), pulse oximetry, 85% (14.90, 6.43-34.90), and % predicted FVC < 80% (13.62, 4.40-41.80) were strongly associated with EE. Attributable fractions for EE were greatest for being overweight (26.7%), followed by male sex (21.5%), pulse oximetry, 85% (16.4%), having metabolic syndrome (14.4%), and % predicted FVC, 80% (9.3%). CONCLUSIONS: We found a lower prevalence of EE than in previous reports in the Peruvian Andes. Although the presence of hypoxemia and decreased vital capacity were strongly associated with excessive erythrocytosis, being overweight or having metabolic syndrome were associated with an important fraction of cases in our study population.