Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome

Kimura, Yumi; Sakamoto, Ryota; Wada, Taizo; Ishimoto, Yasuko; Hirosaki, Mayumi; Konno, Akiko; Chen, Wingling; Ishine, Masayuki; Kosaka, Yasuyuki; Wada, Christopher A.; Nakatsuka, Masahiro; Otsuka, Kuniaki; Fujisawa, Michiko; Wang, Hongxing; Dai, Qi; Yang, Aixia; Gao, Jidong; Li, Zhanquan; Qiao, Haisheng; Zhang, Yongshou; Ge, Ri Li; Okumiya, Kiyohito

doi:10.1111/j.1447-0594.2009.00548.x

Cited by 16 publications

(18 citation statements)

References 30 publications

(40 reference statements)

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“…However, in the present study, the association between OC and adiponectin was not identified. Consistent with other studies , we found an inverse association between OC and leptin. Ducy et al .…”

Section: Discussionsupporting

confidence: 93%

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Osteocalcin is inversely associated with glucose levels in middle‐aged Tibetan men with different degrees of glucose tolerance

Chen

Liu

et al. 2014

Diabetes Metabolism Res

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Section: Discussionsupporting

confidence: 93%

“…Lu et al . found that serum OC was not associated with glucose in nondiabetic women . Abseyi et al .…”

Section: Discussionmentioning

confidence: 95%

Osteocalcin is inversely associated with glucose levels in middle‐aged Tibetan men with different degrees of glucose tolerance

Chen

Liu

et al. 2014

Diabetes Metabolism Res

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“…Such inflexibility and fatty acid oxidation capacities [39, 40] are both implicated in the pathogenesis of type 2 diabetes mellitus. Tibetan highlanders have a relatively low prevalence of diabetes [41], but the diet is also relatively low-calorie [42] and high altitudes are associated with lower body weights among Tibetans [43]. As populations move to lower altitudes and encounter a more industrialized lifestyle and higher calorie diets, however, the metabolic adaptations to altitude could have health implications.…”

Section: Resultsmentioning

confidence: 99%

Metabolic insight into mechanisms of high-altitude adaptation in Tibetans

Simonson

Cooksey

et al. 2012

Molecular Genetics and Metabolism

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Recent studies have identified genes involved in high-altitude adaptation in Tibetans. Genetic variants/haplotypes within regions containing three of these genes (EPAS1, EGLN1, and PPARA) are associated with relatively decreased hemoglobin levels observed in Tibetans at high altitude, providing corroborative evidence for genetic adaptation to this extreme environment. The mechanisms that afford adaptation to high-altitude hypoxia, however, remain unclear. Considering the strong metabolic demands imposed by hypoxia, we hypothesized that a shift in fuel preference to glucose oxidation and glycolysis at the expense of fatty acid oxidation would improve adaptation to decreased oxygen availability. Correlations between serum free fatty acids and lactate concentrations in Tibetan groups living at high altitude and putatively selected haplotypes provide insight into this hypothesis. An EPAS1 haplotype that exhibits a signal of positive selection is significantly associated with increased lactate concentration, the product of anaerobic glycolysis. Furthermore, the putatively advantageous PPARA haplotype is correlated with serum free fatty acid levels, suggesting a possible decrease in the activity of fatty acid oxidation. Although further studies are required to assess the molecular mechanisms underlying these patterns, these associations suggest that genetic adaptation to high altitude involves alteration in energy utilization pathways.

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“…However, globalization has now reached the Himalayan highlands. Residents, even of the highlands, have also experienced an increase in life expectancy, but at the same time a higher rate of lifestyle‐related diseases has been identified 68–72 . The physiological adaptations to the low‐oxygen environment were caused by gradual genetic changes that took place over tens of thousands of years.…”

Section: Expansion Of Field Medicine To Atypical Global Environments mentioning

confidence: 99%

Field medicine: A new paradigm of geriatric medicine

Okumiya

2011

Geriatrics Gerontology Int

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It is only during the last half century that aging came to be truly thought of as a societal issue rather than simply a personal one, as well as a challenge to be tackled by science and medicine. Diseases used to be studied only in hospitals and laboratories, centering on patients treated there. However, caring for elderly people in hospitals provides only a small glimpse into their world. With an advancing aged population, the reality of old age and age-related chronic illnesses takes place in homes and communities. To truly understand the health issues of the elderly, we ventured into communities and visited elderly persons in their homes and cultural environments in Kochi prefecture. The Department of Geriatric Medicine, Kochi Medical School, was the first in Japan to incorporate the Comprehensive Geriatric Assessment in preventive intervention and evaluation of the medical problems of elderly people in field settings, which could not be completely resolved in the hospital. Geriatric findings in field settings in Kochi before (1990-2000) and after (2000-2010) the introduction of the nationwide long-term care insurance system throughout Japan were reviewed. Field medicine also enables us to explore the aging of people living not only in Japan but also in several Asian communities and, further, into those living in atypical environments such as the Himalayan highlands. Based on the geriatric findings of field medicine carried out in sites with different ecology and cultures, we reconsidered the optimal aging situation based on the activities of daily living and quality of life, as well as chronic diseases of elderly people throughout the world. In this review article, we would like to highlight the importance of field medicine as a new paradigm of geriatric medical research.

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Comprehensive geriatric assessment of elderly highlanders in Qinghai, China I: Activities of daily living, quality of life and metabolic syndrome

Cited by 16 publications

References 30 publications

Osteocalcin is inversely associated with glucose levels in middle‐aged Tibetan men with different degrees of glucose tolerance

Osteocalcin is inversely associated with glucose levels in middle‐aged Tibetan men with different degrees of glucose tolerance

Metabolic insight into mechanisms of high-altitude adaptation in Tibetans

Field medicine: A new paradigm of geriatric medicine

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