Abstract
This study aimed to describe lipid profiles and the distribution of glycated hemoglobin (HbA1c) in a sample of a high altitude population of Nepal and to explore associations between these metabolic risk variables and altitude. A cross-sectional survey of cardiovascular disease and associated risk factors was conducted among 521 people living at four different altitude levels, all above 2800 m, in the Mustang and Humla districts of Nepal. Urban participants (residents at 2800 m and 3620 m) had higher total cholesterol (TC) and triglyceride (TG) than rural participants. A high ratio of TC to high-density lipoprotein-cholesterol (HDL) (TC/HDL ≥ 5.0) was found in 23.7% (95% CI 19.6, 28.2) and high TG (≥1.7 mmol/L) in 43.3% (95% CI 38.4, 48.3) of participants overall. Mean HbA1c levels were similar at all altitude levels although urban participants had a higher prevalence of diabetes. Overall, 6.9% (95% CI 4.7, 9.8) of participants had diabetes or were on hypoglycaemic treatment. There was no clear association between lipid profiles or HbA1c and altitude in a multivariate analysis adjusted for possible confounding variables. Residential settings and associated lifestyle practices are more strongly associated with lipid profiles and HbA1c than altitude amongst high altitude residents in Nepal.
Highlights
Dyslipidemia and diabetes mellitus (DM) are key global public health problems
Residential settings and associated lifestyle practices are more strongly associated with lipid profiles and HbA1c than altitude amongst high altitude residents in Nepal
The high altitude (HA) residents of this study are at increased risk of dyslipidemia and pre-diabetes
Summary
Which may secondarily affect lipid and blood glucose concentrations. Hypoxia causes a preference for glucose utilization and decreases uptake of free fatty acids because of oxygen-efficient adaptation [1,3]. Hypoxia alters hepatic lipid oxidation and can increase the levels of triglyceride (TG) [4] and high-density lipoprotein-cholesterol (HDL) [5]. More than 140 million people in the world permanently live at HA, comprising 2% of the global population [6]. Usual residence at an altitude of 2500 m or above is the conventional demarcation for HA [7] because people generally start to experience adverse symptoms such as shortness of breath, increased heart rate, nausea, dizziness, satiety and fatigue above this altitude. The largest populations at HA are 80 million in the Himalayan mountains of Asia and 35 million in the Andean mountains of
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