Correlation between RBC changes and coagulation parameters in high altitude population

Rong Zhang,Xiaochuan Yu,Yuanzhen Shen,Chunhui Yang,Fengjuan Liu,Shengliang Ye,Xi Du,Li Ma,Haijun Cao,Zongkui Wang,Changqing Li

doi:10.1080/16078454.2019.1568658

Rong Zhang, Xiaochuan Yu + Show 9 more

Open Access

https://doi.org/10.1080/16078454.2019.1568658

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Abstract

ABSTRACTObjective: To explore the correlations between RBCs indexes and the basic coagulation parameters, and provide data for further studies on high altitude-induced thrombotic disease.Methods: A total of eligible 433 volunteers were divided into different groups according to HGB concentration and HCT, respectively. PT, APTT, TT and Fbg were measured by clotting assays. HGB content, HCT and PLT count were assessed by automated hematology analyzer.Results: APTT and PT were significantly higher in group 4 (high HGB or HCT groups) (p < 0.05 for all comparison) and PLT count was significantly lower in group 4 than in other groups (p < 0.01 for all comparison). APTT and PT showed negative correlations with HGB concentration (r = −0.168 and −0.165 resp.; both p < 0.01), whereas positive correlations were found between APTT and HCT, PT and HCT (r = 0.225 and 0.258, resp.; both p < 0.01). PLT, TT and Fbg showed no correlation with HGB and HCT.Conclusions: HGB and HCT may not correlate with basic coagulation parameters in high altitude population, their predictive value for high altitude-induced thrombotic disease may relatively independent and this remain to be determined in further studies.

Highlights

It was reported that over 140 million people worldwide permanently live at altitudes >2500 m above sea level
As showed in Figure 1(A,B), activated partial thromboplastin time (APTT) and Prothrombin time (PT) in group 4 of HGB were significantly higher than group 1, group 2 and group 3 (42.3 ± 15.4 sec vs. 38.2 ± 12.8 sec vs. 38.1 ± 12.7 sec vs. 38.1 ± 13.2 sec for APTT, 14.2 ± 2.9 sec vs. 13.0 ± 1.6 sec vs. 12.6 ± 1.7 sec vs. 12.9 ± 2.2 sec for PT, all p < 0.05)
Using multivariable regression analysis, APTT and PT retained to have a significant relationship with HCT (b = 2.042 and 0.363, both p < 0.001; Table 3)

Summary

Introduction

It was reported that over 140 million people worldwide permanently live at altitudes >2500 m above sea level. Low ambient temperature and hypobaric hypoxia are two challenges to life at high altitude (HA) [1,2], with an increased risk of thrombotic diseases following prolonged stay at HA [3,4,5,6]. The environmental conditions in HA affect the morphology and phenotype of blood cells [3]. Red blood cell (RBC) count, hemoglobin (HGB) concentrations and hematocrit (HCT) would reach a fairly high level in most of the individuals following long-term exposure to HA situations. The relationship between HA and factors which may increase the incidence of thrombosis have well documented [11], such as HA and RBC, HA and main clotting factors, but whether there is any association among these factors has not been studied

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