Análisis de los efectos globales que ocasiona la hipoxia hipobárica crónica sobre el estado físico-emocional de los pobladores que residen en altitudes mayores a los 2,500 msnm

Autor: Ortiz-Prado, Esteban
Přispěvatelé: Calvopiña, Manuel, Viscor Carrasco, Ginés, Universitat de Barcelona. Departament de Biologia Cel·lular, Fisiologia i Immunologia
Rok vydání: 2022
Předmět:
Zdroj: TDX (Tesis Doctorals en Xarxa)
TDR. Tesis Doctorales en Red
Fundación Tecnalia Research & Innovation
Dipòsit Digital de la UB
Universidad de Barcelona
Popis: [spa] ANTECEDENTES: A nivel planetario, al menos 200 millones de personas a nivel mundial residen en poblaciones ubicadas a grandes alturas. Vivir o visitar regiones montañosas puede provocar cambios fisiológicos significativos entre quienes visitan estos lugares durante cortos periodos de tiempo o provocar modificaciones adaptativas más crónicas entre quienes residen allí durante varias generaciones. Los seres humanos dependen de la presencia, disponibilidad y utilización de oxígeno para funcionar correctamente y mantener la homeostasis fisiológica alrededor de la respiración. En condiciones de hipoxia, los mecanismos adaptativos a largo plazo o compensatorios a corto plazo generan alteraciones genéticas, anatómicas, fisiológicas y, en algunos casos, patológicas entre los seres humanos. OBJETIVOS: El objetivo de nuestro estudio ha sido doble: desde un punto de vista más general, el de estudiar el impacto epidemiológico que representa el vivir por encima de los 2.500 m sobre el nivel del mar, y, más detalladamente, estudiar las diferencias fisiológicas más evidentes entre dos poblaciones indígenas, genotípicamente idénticas que residen a baja y gran altura. RESULTADOS: a) Diferencias antropométricas Nuestra tesis ha demostrado que las mujeres que residen a bajas alturas tienden a presentar tallas más cortas y mayor peso que sus pares de las grandes alturas, aunque estas diferencias no fueron estadísticamente significativas (p = 0,333). A su vez, los hombres que residen a grandes alturas son más bajos de talla que sus homólogos que viven a bajas alturas, siendo estos resultados estadísticamente significativos (p = 0,019). En relación con la composición corporal, las mujeres de las alturas tienen un porcentaje menor de músculo corporal (-24,8%), mientras que los hombres de la misma región tienen un porcentaje de masa corporal muscular significativamente mayor (+ 13,5%) que sus homólogos de bajas alturas. El porcentaje de grasa corporal fue menor entre las mujeres de las bajas alturas (-15,5%), mientras que entre los hombres no logramos encontrar diferencias estadísticamente significativas. b) Diferencias hematológicas, de perfil lipídico y de riesgo cardiovascular Al comparar estos parámetros, nuestros resultados nos demuestran que la proporción de individuos con sobrepeso y obesidad fue mayor entre los habitantes de las bajas alturas (p
[eng] BACKGROUND: On a planetary level, at least 200 million people of the world's population resides at high altitude. Living or visiting mountainous regions can lead to significant physiological changes among those visiting these places for short periods of time or lead to more chronic adaptive modifications among those who reside there for generations. Human beings depend on the presence of oxygen for proper functioning and to maintain their physiological homeostasis. Under hypoxic conditions, adaptive long-term or compensatory short-term mechanism generate genetic, anatomical, physiological and in some cases pathological alterations among humans. OBJECTIVES: In this sense, we have set ourselves the objective of studying the epidemiological impact of living above 2,500 m above sea level as well as studying the most evident physiological differences between two genotype-controlled indigenous populations residing at low and high altitude. RESULTS: a) Anthropometric differences Our study shows that low altitude women tend to be shorter and heavier, but these differences are not statistically significant (p = 0.333), on the other hand, high altitude men are shorter than their counterparts who live at low altitude (p = 0.019). In relation to body composition, women at high altitudes have less body muscle % (-24.8%) while men at high altitudes have significantly more muscle body mass % (+ 13.5%) than their lowland counterpart. Body fat % is lower among low altitude women (-15.5%) and no differences were found among men. Hematological, lipid profile and cardiovascular risk differences In the low altitude group, 66% were women (n = 78) and 34% (n = 40) were men, whereas in the high altitude group, 59% (n = 56) were women and 41% (n = 41%) were men. We found the proportion of overweight and obese individuals to be higher among low altitude dwellers (p < 0.05). Red blood cells (RBCs), hemoglobin concentration were higher among high altitude dwellers and the erythrocyte size was found to be smaller and SpO2% lower at high altitude. The group located at low altitude also showed lower levels of plasma cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). b) Optimism and health self-perception High-altitude dwellers presented lower scores in all the studied dimensions of SF-36. Significant differences were found for the Role limitation sphere due to Vitality (p = 0.005), Mental Health (p = 0.002) and social functioning (p = 0.005). In all the cases, participants living at low altitudes scored higher than those living at high altitude. Lowland women were more optimistic than their high-altitude counterparts c) Lung function and spirometry parameters People from Oyacachi (3.800 m) showed a higher predicted value than those from Limoncocha (230 m). The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001). The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants. CONCLUSIONS: Living at an altitude elicits well-known adaptive physiological changes such as erythrocyte count, hemoglobin concentration, hematocrit level, and serum glucose level. We also report clinical differences in the plasma lipid profile, with higher levels of cholesterol, HDL, and LDL in inhabitants of the Andes Mountain vs. their Amazonian basin peers. The anthropometric differences vary according to sex, demonstrating that high altitude population are in general lighter and shorter than their low altitude controls. Men at high altitude have more muscled bodies than their lowland counterpart but their biological age was older than their corresponding chronological age. High altitude dwellers had greater lung capacity than their low-altitude peers, a finding physiologically plausible according to published literature. When analyzing the spirometry patterns obtained in these populations, it was evident that greater lung capacities are probably linked to bigger lungs, improving systemic oxygenation despite low oxygen availability.
Databáze: OpenAIRE
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