Is Smoking a Predictor for Acute Mountain Sickness? Findings From a Meta-Analysis

Vinnikov, Denis; Blanc, Paul D.; Steinmaus, Craig

doi:10.1093/ntr/ntv218

Cited by 13 publications

(12 citation statements)

References 41 publications

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“…To our knowledge, prior our study, only one meta-analysis explored the association between smoking and AMS and found that smoking was not significantly associated with AMS [22]. Different selection criteria may lead to different results; we used strict inclusion and exclusion criteria and obtained results that contrasted with those of the previous study.…”

Section: Discussionmentioning

confidence: 99%

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Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

Wang

et al. 2016

Military Med Res

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BackgroundPeople rapidly ascending to high altitudes (>2500 m) may suffer from acute mountain sickness (AMS). The association between smoking and AMS risk remains unclear. Therefore, we performed a meta-analysis to evaluate the association between smoking and AMS risk.MethodsThe association between smoking and AMS risk was determined according to predefined criteria established by our team. Meta-analysis was conducted according to the PRISMA guidelines. We included all relevant studies listed in the PubMed and Embase databases as of September 2015 in this meta-analysis and performed systemic searches using the terms “smoking”, “acute mountain sickness” and “risk factor”. The included studies were required to provide clear explanations regarding their definitions of smoking, the final altitudes reached by their participants and the diagnostic criteria used to diagnose AMS. Odds ratios (ORs) were used to evaluate the association between smoking and AMS risk across the studies, and the Q statistic was used to test OR heterogeneity, which was considered significant when P < 0.05. We also computed 95% confidence intervals (CIs). Data extracted from the articles were analyzed with Review Manager 5.3 (Cochrane Collaboration, Oxford, UK).ResultsWe used seven case-control studies including 694 smoking patients and 1986 non-smoking controls to analyze the association between smoking and AMS risk. We observed a significant association between AMS and smoking (OR = 0.71, 95% CI 0.52–0.96, P = 0.03).ConclusionsWe determined that smoking may protect against AMS development. However, we do not advise smoking to prevent AMS. More studies are necessary to confirm the role of smoking in AMS risk.

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Section: Discussionmentioning

confidence: 99%

“…Recently, Vinnikov et al [22] performed a meta-analysis showing that smoking was not significantly associated with AMS. Different detailed method might get different conclusions.…”

Section: Introductionmentioning

confidence: 99%

Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

Wang

et al. 2016

Military Med Res

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“…Exercise may aggravate acute high-altitude disease, but good physical fitness is not a protective factor. A meta-analysis by Vinnikov D showed that smoking may also be a risk factor 33 , but there was no significant difference in body mass index, age, or smoking and drinking status between the AMS group and the non-AMS group after high-altitude exposure, indicating that our sample homogeneity was relatively good. However, our current report indicated that the rs2070699 polymorphism within the EDN1 gene was an independent predictor of AMS, which was notable.…”

Section: Discussionmentioning

confidence: 75%

EDN1 gene potentially involved in the development of acute mountain sickness

Liu

Zhang

et al. 2020

Sci Rep

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Previous investigations have indicated that environmental and genetic factors collectively contribute to the development of acute mountain sickness (AMS), but whether the EDN1 gene is involved in AMS remains to be elucidated. A total of 356 healthy male soldiers who had not traveled to high altitudes in the previous 12 months were enrolled in our study. All participants were taken by plane from 500 m (Chengdu in Sichuan Province) to a 3700 m highland (Lhasa) within 2 hours. Clinical data were collected within 24 hours, and pulmonary function parameters were completed simultaneously. Genotypes were obtained by using iMLDR genotyping assays. A total of 237 soldiers (66.57%) presented AMS symptoms, including headache, dizziness, gastrointestinal upset and fatigue. Soldiers with AMS showed an increase in heart rate (HR), plasma tryptophan and serotonin, and a decrease in SaO2, FEV1, PEF, FVC, V75, V50, V25 and MMF (all P < 0.01). Notably, allele T in single nucleotide polymorphism (SNP) rs2070699 showed a positive correlation with the occurrence of AMS. A general linear regression analysis showed that rs2060799, Mean Arterial Pressure (MAP), SaO2, FVC, tryptophan and serotonin were independent predictors for the occurrence of AMS. Importantly, the area under the curve (AUC) values for tryptophan (0.998), serotonin (0.912) and FVC (0.86) had diagnostic specificity and sensitivity. Our results demonstrated that AMS is accompanied by changes in lung function parameters, increased plasma tryptophan and serotonin levels, and that the EDN1 polymorphism is a potential risk factor for AMS.

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“… 17 However, Li et al , 21 and Vinnikov et al 22 found smoking to be a risk factor (RR=1.11 and HR=1.9, respectively) when studying occupational cohorts or climbers commuting to very high altitudes (above 4000 masl), results that were in line with those shown in the meta-analysis performed by Vinnikov et al (pooled OR=0.88, 95% CI 0.74 to 1.05). 23 …”

Section: Discussionmentioning

confidence: 99%

“… 12–15 Around 30% of the world’s population declare being active smokers, yet there is a notable lack of consensus regarding the relationship between smoking and AMS risk. A recent meta-analysis performed by Vinnikov et al 16 showed that there was no significant association between smoking and AMS, while another performed by Xu et al 17 found an association between smoking and AMS, the former being a protective factor. The smoking status of travellers is not routinely explored, potentially resulting in an incomplete or misguided approach in the pretravel advice and treatment they receive.…”

Section: Introductionmentioning

confidence: 97%

Relationship of altitude mountain sickness and smoking: a Catalan traveller’s cohort study

et al. 2017

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ObjectivesThe aim of this study is to analyse the relationship between smoking and altitude mountain sickness in a cohort of travellers to 2500 metres above sea level (masl) or higher.SettingTravel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain.ParticipantsA total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status.OutcomesThe main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria.ResultsAMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached.ConclusionsThese results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.

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Is Smoking a Predictor for Acute Mountain Sickness? Findings From a Meta-Analysis

Cited by 13 publications

References 41 publications

Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies

EDN1 gene potentially involved in the development of acute mountain sickness

Relationship of altitude mountain sickness and smoking: a Catalan traveller’s cohort study

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