https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)67632-5.pdf

Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study

Wu, Tianyi, and Bengt Kayser. High altitude adaptation in Tibetans. High Alt. Med. Biol. 7:193–208, 2006.—Since the beginning of the Himalayan climbing era, the anecdotal extraordinary physical performance at high altitude of Sherpas and Tibetans has intrigued scientists interested in altitude adaptation. These ethnic groups may have been living at high altitude for longer than any other population, and the hypothesis of a possible evolutionary genetic adaptation to altitude makes sense. Reviewed here is the evidence as to whether Tibetans are indeed better adapted for life and work at high altitude as compared to other populations and, if so, whether this better adaptation might be inborn. Tibetans, compared to lowlanders, maintain higher arterial oxygen saturation at rest and during exercise and show less loss of aerobic performance with increasing altitude. Tibetans have greater hypoxic and hypercapnic ventilatory responsiveness, larger lungs, better lung function, and greater lung diffusing capacity t...

High altitude adaptation in Tibetans.

Anecdotal evidence surrounding Tibetans' and Sherpas' exceptional tolerance to hypobaric hypoxia has been recorded since the beginning of high-altitude exploration. These populations have successfully lived and reproduced at high altitude for hundreds of generations with hypoxia as a constant evolutionary pressure. Consequently, they are likely to have undergone natural selection toward a genotype (and phenotype) tending to offer beneficial adaptation to sustained hypoxia. With the advent of translational human hypoxic research, in which genotype/phenotype studies of healthy individuals at high altitude may be of benefit to hypoxemic critically ill patients in a hospital setting, high-altitude natives may provide a valuable and intriguing model. The aim of this review is to provide a comprehensive summary of the scientific literature encompassing Tibetan and Sherpa physiological adaptations to a high-altitude residence. The review demonstrates the extent to which evolutionary pressure has refined the physiology of this high-altitude population. Furthermore, although many physiological differences between highlanders and lowlanders have been found, it also suggests many more potential avenues of investigation.

https://www.physiology.org/doi/pdf/10.1152/physiol.00018.2014

King of the Mountains: Tibetan and Sherpa Physiological Adaptations for Life at High Altitude

Objective In clinical practice, spirometry is an extremely useful test that requires strict quality control, an appropriate strategy for interpretation, and reliable reference values. The aim of this study was to report spirometric reference values for 5 cities in Latin America. Patients and methods From data for 5315 subjects who had undergone spirometry in the PLATINO study in Caracas, Mexico City, Santiago, Sao Paulo, and Montevideo, we selected information for 906 (17%) individuals aged between 40 years and 90 years to provide reference values. The chosen subjects had never smoked, were asymptomatic, had not been diagnosed with lung disease, and were not obese. Multiple regression models were constructed with the following spirometric parameters: forced expiratory volume in 1 second (FEV1) and in 6 seconds (FEV6), peak expiratory flow, forced vital capacity (FVC), FEV1/FEV6, FEV1/FVC, and forced midexpiratory flow rate. Height, sex, and age were also included in the model. Results Average values for the subjects studied were similar to those for the white North American population and the Mexican-American population of the third National Health and Nutrition Examination Survey, but exceeded those of the black population of the same survey by 20%. Conclusions The proposed reference values are an improvement on those currently available for Latin America because the participants were chosen by population sampling methods and standardized up-to-date methodology was used.

http://platino-alat.org/docs/paper_perez-padilla_2006_ENG.pdf

Spirometric Reference Values in 5 Large Latin American Cities for Subjects Aged 40 Years or Over

Objetivo La espirometria es una prueba de gran utilidad clinica, que requiere un estricto control de calidad, una estrategia de interpretacion y valores de referencia adecuados. El proposito del presente trabajo es comunicar los valores de referencia para la espirometria en 5 ciudades de Latinoamerica. Pacientes y metodos El estudio PLATINO se llevo a cabo en Caracas, Mexico, Santiago, Sao Paulo y Montevideo e incluyo a un total de 5.315 sujetos con espirometria realizada. De ellos, se estudio a 906 (17%) que tenian entre 40 y 90 anos de edad para crear valores de referencia, porque nunca habian fumado, estaban asintomaticos y no tenian enfermedad pulmonar diagnosticada ni obesidad. Se efectuaron modelos de regresion multiple con los valores espirometricos –volumen espiratorio forzado en el primer segundo (FEV 1 ) y en 6 s (FEV 6 ), flujo espiratorio maximo, capacidad vital forzada (FVC), FEV 1 /FEV 6 , FEV 1 /FVC y flujo mesoespiratorio forzado–, la talla, el sexo y la edad. Resultados Los sujetos estudiados presentaron en promedio valores similares a los de la poblacion norteamericana blanca y americana de origen mexicano del estudio NHANES III, pero superiores a los de la poblacion negra en un 20%. Conclusiones Los valores de referencia propuestos representan una ventaja sobre los disponibles en la actualidad en Latinoamerica, ya que se eligio a los participantes por metodos de muestreo poblacional y el metodo empleado es estandarizado y actualizado.

http://platino-alat.org/docs/paper_perez-padilla_2006_ESP.pdf

Valores de referencia espirométrica en 5 grandes ciudades de Latinoamérica para sujetos de 40 o más años de edad

We studied residents of high altitude in Ladakh, India, to determine the effects of altitude, age, gender, and ethnicity on gas exchange and pulmonary function. Physical examinations, including pulse oximetry, hemoglobin concentration, end-tidal PCO2, and pulmonary function, were conducted on resting Ladakhi and Tibetan subjects at altitudes of 3300, 4200, and 4500 m. A total of 574 men and women, ranging in age from 17 to 82, were studied. At 3300 m, Ladakhis had higher heart rates than Tibetans in both genders and higher PETCO2 in women. Above 4000 m, 21 of the 141 men studied (15%) had Hb concentrations higher than 20 g/dL, with one confirmed case of Monge's disease. There was no gender difference in SaO2 at any altitude except for pregnant women. At 4600 m, Tibetans had significantly higher peak flows and lower PETCO2 than Ladakhis. Ladakhi men had higher diastolic BP than women (91 vs. 81), with no difference in systolic BP. There was no gender difference in BP for Tibetans. An important spirometry f...

Cardiopulmonary Function in High Altitude Residents of Ladakh

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Cardiopulmonary Function in High Altitude Residents of Ladakh