Austrian Moderate Altitude Studies (AMAS): benefits of exposure to moderate altitudes (1,500–2,500 m)

Schobersberger, Wolfgang; Leichtfried, Veronika; Müeck-Weymann, Michael; Humpeler, Egon

doi:10.1007/s11325-009-0286-y

Cited by 46 publications

(30 citation statements)

References 29 publications

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“…Furthermore, 5-10 days of adaptation to hypoxia returns hyperglycemia to basal levels in healthy people (5). Moreover chronic hypoxic exposure reduces fasting insulin and improves insulin resistance in type 2 diabetic patients (44)(45)(46) and decreases the insulin dosage in type 1 diabetic patients (47,48). Of note, lower insulin levels or reduced insulin signaling is beneficial for health and longevity (49,50).…”

Section: Discussionmentioning

confidence: 99%

Inactivation of Corticotropin-Releasing Hormone–Induced Insulinotropic Role by High-Altitude Hypoxia

et al. 2014

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We have shown that hypoxia reduces plasma insulin, which correlates with corticotropin-releasing hormone (CRH) receptor 1 (CRHR1) in rats, but the mechanism remains unclear. Here, we report that hypobaric hypoxia at an altitude of 5,000 m for 8 h enhances rat plasma CRH, corticosterone, and glucose levels, whereas the plasma insulin and pancreatic ATP/ADP ratio is reduced. In islets cultured under normoxia, CRH stimulated insulin release in a glucose-and CRH-level-dependent manner by activating CRHR1 and thus the cAMP-dependent protein kinase pathway and calcium influx through L-type channels. In islets cultured under hypoxia, however, the insulinotropic effect of CRH was inactivated due to reduced ATP and cAMP and coincident loss of intracellular calcium oscillations. Serum and glucocorticoid-inducible kinase 1 (SGK1) also played an inhibitory role. In human volunteers rapidly ascended to 3,860 m, plasma CRH and glucose levels increased without a detectable change in plasma insulin. By contrast, volunteers with acute mountain sickness (AMS) exhibited a marked decrease in HOMA insulin sensitivity (HOMA-IS) and enhanced plasma CRH. In conclusion, hypoxia may attenuate the CRH-insulinotropic effect by reducing cellular ATP/ADP ratio, cAMP and calcium influx, and upregulated SGK1. Hypoxia may not affect HOMA-IS in healthy volunteers but reduces it in AMS volunteers.To enjoy social activities, millions of people travel to high altitudes every year. High-altitude hypoxia often induces dysfunction and illness, particularly acute mountain sickness (AMS) (1). During the construction of the QinghaiTibet railway (at altitudes of 3,000-5,000 m) in China, .100,000 construction workers were involved, and 51% of them developed AMS (2). Moreover, since the railway began service, .10 million travelers have visited the Tibet region in 2012, of whom 31% developed AMS despite traveling with an oxygen supply on the train (3). Increasing evidence in both humans and animals suggests that exposure to either high-altitude or hypobaric hypoxia influences plasma insulin levels and glucose homeostasis, depending on the oxygen level and duration of exposure (4-9). We previously showed that subacute hypoxia at an altitude of 5,000 m for 5 days reduces plasma insulin in rats, and this effect is blocked by a corticotropin-releasing hormone (CRH) receptor 1 (CRHR1) antagonist in vivo (10). However, the underlying mechanisms have not been clearly addressed.Insulin, the unique hypoglycemic hormone, plays a crucial role in maintaining glucose sensing in pancreatic b-cells and regulating glucose uptake in a variety of tissues and cells during health and disease (11,12). Apart from glucose, many neural and endocrine hormones regulate pancreatic insulin release (13). In particular, CRH is the key regulator of the hypothalamic-pituitary-adrenal (HPA) axis; is activated by a variety of stressors, including hypoxia; and mediates a variety of neural and endocrine

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Section: Discussionmentioning

confidence: 99%

Inactivation of Corticotropin-Releasing Hormone–Induced Insulinotropic Role by High-Altitude Hypoxia

et al. 2014

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“…In a population-based study, it was shown that obesity risk was five times higher for those living at altitudes < 500 m above sea level as compared to residents of > 3000 m altitude (Voss et al, 2013). Recent studies demonstrated that high-altitude environment could be used in treatment of obesity (Schobersberger et al, 2010;Urdampilleta et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Chronic Intermittent High Altitude Exposure, Occupation, and Body Mass Index in Workers of Mining Industry

Esenamanova

Kochkorova

Tsivinskaya

et al. 2014

High Altitude Medicine & Biology

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The obesity and overweight rates in population exposed to chronic intermittent exposure to high altitudes are not well studied. The aim of the retrospective study was to evaluate whether there are differences in body mass index in different occupation groups working in intermittent shifts at mining industry at high altitude: 3800-4500 meters above sea level. Our study demonstrated that obesity and overweight are common in workers of high altitude mining industry exposed to chronic intermittent hypoxia. The obesity rate was lowest among miners as compared to blue- and white-collar employees (9.5% vs. 15.6% and 14.7%, p=0.013). Obesity and overweight were associated with older age, higher rates of increased blood pressure (8.79% and 5.72% vs. 1.92%), cholesterol (45.8% and 45.6% vs. 32.8%) and glucose (4.3% and 1.26% vs. 0.57%) levels as compared to normal body mass index category (p<0.0001 for all). There were differences in patterns of cholesterol and glucose levels in men and women employees according to occupation type. In conclusion, obesity and overweight rates are prevalent and associated with increase in blood pressure, cholesterol, and glucose levels in workers of mining industry exposed to intermittent high-altitude hypoxia. Therefore, assessment and monitoring of body mass index seems to be essential in those who live and work at high altitudes to supply the correct nutrition, modify risk factors, and prevent related disorders.

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“…In a healthy individual undergoing a trek in the Himalayas at a mean altitude of 3900 m we described a significant increase in the number and clonogenic activity of EPCs one day after the trek, returning to normal after 45 days at sea level (Ciulla et al, 2005). A recent study conducted on healthy volunteers participating in a one-week hiking program on the Austrian Alps at 1700 m reported an increase in circulating EPCs (Schobersberger et al, 2010). It must however be remarked that in the case of these high-and moderate-altitude studies it is not possible to dissociate the effects of hypoxia from those of physical activity which is also a powerful stimulus for EPC upregulation Laufs et al, 2004).…”

Section: Hypoxia: a Common Cause Of Cell Damagementioning

confidence: 77%

Advances in Regenerative Medicine

Schantz¹,

Hutmacher²

2016

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Austrian Moderate Altitude Studies (AMAS): benefits of exposure to moderate altitudes (1,500–2,500 m)

Abstract: Active vacations at moderate altitude are associated with a variety of positive health effects in persons with metabolic syndrome and in healthy subjects.

Cited by 46 publications

References 29 publications

Inactivation of Corticotropin-Releasing Hormone–Induced Insulinotropic Role by High-Altitude Hypoxia

Inactivation of Corticotropin-Releasing Hormone–Induced Insulinotropic Role by High-Altitude Hypoxia

Chronic Intermittent High Altitude Exposure, Occupation, and Body Mass Index in Workers of Mining Industry

Advances in Regenerative Medicine

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