Hemoglobin concentration of young men at residential altitudes between 200 and 2000m mirrors Switzerland's topography

Staub, Kaspar; Haeusler, Martin; Bender, Nicole; Морозова, Ирина; Eppenberger, Patrick; Panczak, Radoslaw; Zwahlen, Marcel; Schaer, Dominik J.; Maggiorini, Marco; Ulrich, Silvia; Gassmann, N; Muckenthaler, Martina U.; Rühli, Frank J; Gassmann, Max

doi:10.1182/blood.2019004135

Cited by 15 publications

(26 citation statements)

References 18 publications

(19 reference statements)

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“…As presented in our recent work ( Staub et al, 2020 ), we found a persistent impact of residential altitude on elevated Hb levels among the Swiss conscripts. Based on these data, we now go one step further, and hypothesize that young men living at moderate altitude perform better both in aerobic endurance and in muscle power tests compared to young men living at lower altitude.…”

Section: Introductionsupporting

confidence: 78%

“…Hb was measured on a Siemens Advia 120, creatinine and CRP on an Advia 1650 ( Bruggisser et al, 2016 ). We chose to analyze these three blood parameters for the following reasons: An increase or decrease of hemoglobin has a significant impact on physical performance ( Mairbäurl et al, 2013 ) and altitude influences hemoglobin ( Staub et al, 2020 ). Higher serum creatinine is found in athletic populations.…”

Section: Methodsmentioning

confidence: 99%

“…Another factor influencing metabolic parameters and physical performance is residential altitude, with even moderate altitudes influencing hemoglobin levels ( Sharma et al, 2019 ; Staub et al, 2020 ). The oxygen sensing system of renal cells is triggered by hypoxemia that in turn induces erythropoietin expression.…”

Section: Introductionmentioning

confidence: 99%

“…Switzerland is an ideal testing ground for such studies because the nation includes geographical areas at low to moderate residential altitudes (where data for broadly varying residential altitudes are much more readily available) and provides high quality conscription data ( Panczak et al, 2014 ). These data cover more than 90% of annual birth cohorts of Swiss men and were previously analyzed separately in the context of excess weight ( Panczak et al, 2014 ), metabolic parameters ( Staub et al, 2018 ), physical performance ( Wyss et al, 2019 ), and altitude ( Staub et al, 2020 ). Here we combined, for the first time, high-quality data from the aerobic endurance and muscle power tests with anthropometric data and blood parameters from the medical examination, which also includes socio-demographic data such as the altitude of the place of residence, occupational background and level of urbanization (urbanicity) of over 100,000 young Swiss men.…”

Section: Introductionmentioning

confidence: 99%

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Residential Altitude Associates With Endurance but Not Muscle Power in Young Swiss Men

et al. 2020

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Introduction Physical fitness benefits health. However, there is a research gap on how physical fitness, particularly aerobic endurance capacity and muscle power, is influenced by residential altitude, blood parameters, weight, and other cofactors in a population living at low to moderate altitudes (300–2100 masl). Materials and Methods We explored how endurance and muscle power performance changes with residential altitude, Body Mass Index (BMI), hemoglobin and creatinine levels among 108,677 Swiss men aged 18–22 years (covering >90% of Swiss birth cohorts) conscripted to the Swiss Armed Forces between 2007 and 2012. The test battery included a blood test of about 65%, a physical evaluation of about 85%, and the BMI of all conscripts. Results Residential altitude was significantly associated with endurance ( p < 0.001) but not with muscle power performance ( p = 0.858) after adjusting for all available cofactors. Higher BMI showed the greatest negative association with both endurance and muscle power performance. For muscle power performance, the association with creatinine levels was significant. Elevated C-reactive protein (CRP) and hemoglobin levels were stronger contributors in explaining endurance than muscle power performance. Conclusion We found a significant association between low to moderate residential altitude and aerobic endurance capacity even after adjustment for hemoglobin, creatinine, BMI and sociodemographic factors. Non-assessed factors such as vitamin D levels, air pollution, and lifestyle aspects may explain the presented remaining association partially and could also be associated with residential altitude. Monitoring the health and fitness of young people and their determinants is important and of practical concern for disease prevention and public health implications.

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Section: Introductionsupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Residential Altitude Associates With Endurance but Not Muscle Power in Young Swiss Men

et al. 2020

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“…Interestingly, Staub et al recently showed that adaptation to altitude is far more subtle than previously thought [13]. In contrast to the general assumption that adaptation to altitude only occurs above 2500 masl, Staub et al found increases in hemoglobin concentration and thus oxygen carrying capacity from 300 masl onwards in Swiss men.…”

Section: "Into Thin Air": Living High or Staying Lowmentioning

confidence: 94%

Recent Advancements in Hematology: Knowledge, Methods and Dissemination, Part 1

Fitzgibbon

Park

Cook

et al. 2020

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Increased blood reactive oxygen species and hepcidin in obstructive sleep apnea precludes expected erythrocytosis

et al. 2023

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Obstructive sleep apnea (OSA) causes intermittent hypoxia during sleep. Hypoxia predictably initiates an increase in the blood hemoglobin concentration (Hb); yet in our analysis of 527 patients with OSA, >98% did not have an elevated Hb. To understand why patients with OSA do not develop secondary erythrocytosis due to intermittent hypoxia, we first hypothesized that erythrocytosis occurs in these patients, but is masked by a concomitant increase in plasma volume. However, we excluded that explanation by finding that the red cell mass was normal (measured by radionuclide labeling of erythrocytes and carbon monoxide inhalation). We next studied 45 patients with OSA before and after applying continuous positive airway pressure (CPAP). We found accelerated erythropoiesis in these patients (increased erythropoietin and reticulocytosis), but it was offset by neocytolysis (lysis of erythrocytes newly generated in hypoxia upon return to normoxia). Parameters of neocytolysis included increased reactive oxygen species from expanded reticulocytes' mitochondria. The antioxidant catalase was also downregulated in these cells from hypoxia‐stimulated microRNA‐21. In addition, inflammation‐induced hepcidin limited iron availability for erythropoiesis. After CPAP, some of these intermediaries diminished but Hb did not change. We conclude that in OSA, the absence of significant increase in red cell mass is integral to the pathogenesis, and results from hemolysis via neocytolysis combined with inflammation‐mediated suppression of erythropoiesis.

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Hemoglobin concentration of young men at residential altitudes between 200 and 2000m mirrors Switzerland's topography

Cited by 15 publications

References 18 publications

Residential Altitude Associates With Endurance but Not Muscle Power in Young Swiss Men

Residential Altitude Associates With Endurance but Not Muscle Power in Young Swiss Men

Recent Advancements in Hematology: Knowledge, Methods and Dissemination, Part 1

Increased blood reactive oxygen species and hepcidin in obstructive sleep apnea precludes expected erythrocytosis

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