Elevated Red Cell Distribution Width as a Potential Marker of Acute Mountain Sickness in Chinese Young Men Upon Rapidly Ascending to 3,650 m
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Background Elevated red cell distribution width (RDW) has been implicated in chronic mountain sickness; however, its relationship with acute mountain sickness (AMS) remains uncertain. We aimed to evaluate the association between elevated RDW and AMS among Chinese young men undergoing high-altitude air ascent. Methods 157 participants (median age, 22 years) were enrolled and passively ascended primarily by air from 500 m to 3,650 m, spending approximately 3.5 hours. Participants were classified as AMS+ and AMS− based on their Lake Louise AMS score (LLS) after 24 hours at 3,650 m. Measurements included heart rate (HR), blood pressure, pulse oximeter saturation (SpO), and complete blood count (CBC). Statistical analyses included correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results The prevalence of AMS at 3,650 m was 45%. AMS+ participants had higher HR and RDW and lower SpOthan AMS− participants. LLS was positively correlated with age, BMI, HR, and RDW, and negatively correlated with SpO. Adjusted logistic regression revealed independent risk factors for AMS, including lower SpO(odds ratio [OR] = 0.809,< 0.01), higher RDW coefficient of variation (RDW–CV) (OR = 2.790,< 0.01), and a higher neutrophil-to-monocyte ratio (OR = 1.114,< 0.05). ROC curve analysis demonstrated that elevated RDW–CV is a significant diagnostic indicator for AMS, with an optimal cutoff of 13.7, yielding a sensitivity of 94.37%, specificity of 45.35
Abstract
Background Elevated red cell distribution width (RDW) has been implicated in chronic mountain sickness; however, its relationship with acute mountain sickness (AMS) remains uncertain. We aimed to evaluate the association between elevated RDW and AMS among Chinese young men undergoing high-altitude air ascent. Methods 157 participants (median age, 22 years) were enrolled and passively ascended primarily by air from 500 m to 3,650 m, spending approximately 3.5 hours. Participants were classified as AMS+ and AMS− based on their Lake Louise AMS score (LLS) after 24 hours at 3,650 m. Measurements included heart rate (HR), blood pressure, pulse oximeter saturation (SpO), and complete blood count (CBC). Statistical analyses included correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results The prevalence of AMS at 3,650 m was 45%. AMS+ participants had higher HR and RDW and lower SpOthan AMS− participants. LLS was positively correlated with age, BMI, HR, and RDW, and negatively correlated with SpO. Adjusted logistic regression revealed independent risk factors for AMS, including lower SpO(odds ratio [OR] = 0.809,< 0.01), higher RDW coefficient of variation (RDW–CV) (OR = 2.790,< 0.01), and a higher neutrophil-to-monocyte ratio (OR = 1.114,< 0.05). ROC curve analysis demonstrated that elevated RDW–CV is a significant diagnostic indicator for AMS, with an optimal cutoff of 13.7, yielding a sensitivity of 94.37%, specificity of 45.35%, and an area under the curve (AUC) of 0.703. Conclusion The findings suggest that elevated RDW–CV is linked to an increased risk of AMS among Chinese young men primarily undergoing air ascent to 3,650 m.