Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis

Abstract

BackgroundWhen lowlanders rapidly ascend to altitudes > 2500 m, they may develop acute mountain sickness (AMS). The individual susceptibility, ascending velocity, time spent at altitude, activity levels and altitude reached are considered risk factors for AMS. However, it is not clear whether sex is a risk factor. The results have been inconclusive. We conducted a meta-analysis to test whether there were sex-based differences in the prevalence of AMS using Lake Louise Scoring System.MethodsSystematic searches were performed in August 2019 in EMBASE, PubMed, and Web of Science for prospective studies with AMS data for men and women. The titles and abstracts were independently checked in the primary screening step, and the selected full-text articles were independently assessed in the secondary screening step by the two authors (YPH and JLW) based on pre-defined inclusion criteria. The meta-analysis was performed using by the STATA 14.1 software program. A random-effects model was employed.ResultsEighteen eligible prospective studies were included. A total of 7669 participants (2639 [34.4%] women) were tested. The results showed that there was a statistically significant higher prevalence rate of AMS in women than in men (RR = 1.24, 95%CI 1.09–1.41), regardless of age or race. Howerver, the heterogeneity was significant in the analysis (Tau2 = 0.0403, Chi2 = 50.15, df = 17; I2 = 66.1%, P = 0.000), it was main caused by different numbers of subjects among the studies (coefficient = − 2.17, P = 0.049). Besides, the results showed that there was no evidence of significant publication bias in the combined studies on the basis of Egger’s test (bias coefficient = 1.48, P = 0.052) and Begg’s test (P = 0.130).ConclusionsAccording to this study, the statistically significant finding emerging from this study was that women have a higher prevalence of AMS. However, the authors could not exclude studies where patients were on acetazolamide. Our analysis provided a direction for future studies of the relationship of sex and the risk of AMS, such as the pathological mechanism and prevention research.

Association between physiological responses after exercise at low altitude and acute mountain sickness upon ascent is sex-dependent

“…Sex differences in AMS has been previously report, but with inconsistent conclusions. A meta-analysis supported higher susceptibility in women [24]. In the current study, we confirmed higher rate of AMS in women.…”

Differences in Tolerance to Hypoxia: Physiological, Biochemical, and Molecular-Biological Characteristics

“…However, according to [ 116 ], susceptibility to AMS does not differ according to gender. The authors of [ 117 , 118 ] found that women are more likely to develop AMS, but at the same time there are data demonstrating that, vice versa, men are more predisposed to suffer from AMS than women [ 119 ]. Thus, this question remains not fully understood and requires further research paying attention to the reproductive status and female estrous cycle phase.…”

Coronavirus Disease 2019 Related Clinical Studies: A Cross-Sectional Analysis

“…As a result, only 16.9% of registered studies involved children. As a factor of disease outcomes ( Hou et al, 2019 ), only 2.5% studies focus on the participants’ gender. The included clinical studies involved disease prevention, diagnostic accuracy, drug treatment, medical devices, prognosis, as well as treatment of critical COVID-19.…”