The increase in hemoglobin concentration with altitude differs between world regions and is less in children than in adults

• Verfasst von: Mairbäurl, Heimo [VerfasserIn]
• Verfasst von: Kilian, Samuel [VerfasserIn]
• Verfasst von: Seide, Svenja [VerfasserIn]
• Verfasst von: Muckenthaler, Martina [VerfasserIn]
• Verfasst von: Gassmann, Max [VerfasserIn]
• Verfasst von: Benedict, Rukundo K. [VerfasserIn]
• Titel: The increase in hemoglobin concentration with altitude differs between world regions and is less in children than in adults
• Verf.angabe: Heimo Mairbäurl, Samuel Kilian, Svenja Seide, Martina U. Muckenthaler, Max Gassmann, Rukundo K. Benedict
• E-Jahr: 2023
• Jahr: April 2023
• Umfang: 15 S.
• Fussnoten: Gesehen am 19.05.2023
• Titel Quelle: Enthalten in: HemaSphere
• Ort Quelle: [Philadelphia, Pennsylvania] : Wolters Kluwer Health, 2017
• Jahr Quelle: 2023
• Band/Heft Quelle: 7(2023), 4 vom: Apr., Artikel-ID e854, Seite 1-15
• ISSN Quelle: 2572-9241
• DOI: doi:10.1097/HS9.0000000000000854
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1845721683

Abstract

To compensate for decreased oxygen partial pressure, high-altitude residents increase hemoglobin concentrations [Hb]. The elevation varies between world regions, posing problems in defining cutoff values for anemia or polycythemia. The currently used altitude adjustments (World Health Organization [WHO]), however, do not account for regional differences. Data from The Demographic and Health Survey (DHS) Program were analyzed from 32 countries harboring >4% of residents at altitudes above 1000 m. [Hb]-increase, (ΔHb/km altitude) was calculated by linear regression analysis. Tables show 95% reference intervals (RIs) for different altitude ranges, world regions, and age groups. The prevalence of anemia and polycythemia was calculated using regressions in comparison to WHO adjustments. The most pronounced Δ[Hb]/km was found in East Africans and South Americans while [Hb] increased least in South/South-East Asia. In African regions and Middle East, [Hb] was decreased in some altitude regions showing inconsistent changes in different age groups. Of note, in all regions, the Δ[Hb]/km was lower in children than in adults, and in the Middle East, it was even negative. Overall, the Δ[Hb]/km from our analysis differed from the region-independent adjustments currently suggested by the WHO resulting in a lower anemia prevalence at very high altitudes. The distinct patterns of Δ[Hb] with altitude in residents from different world regions imply that one single, region-independent correction factor for altitude is not be applicable for diagnosing abnormal [Hb]. Therefore, we provide regression coefficients and reference-tables that are specific for world regions and altitude ranges to improve diagnosing abnormal [Hb].