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Obesity: Associations with Acute Mountain Sickness

Ge Ri-Li, MD, PhD; Paul J. Chase, MEd; Sarah Witkowski, MS; Brenda L. Wyrick, BSN; Jeff A. Stone, DO; Benjamin D. Levine, MD; and Tony G. Babb, PhD
[+] Article and Author Information

From the Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, and the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, and the Institute of High Altitude Medicine, Qinghai Medical College, Xining, Qinghai, China.


Acknowledgments: The authors thank all laboratory staff, hypobaric chamber staff, and biochemistry laboratory technicians for their contributions and support.

Grant Support: By the U.S. Wilderness Medical Society and the American Lung Association (CI-015-N).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Tony G. Babb, PhD, Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX 75231.

Current Author Addresses: Dr. Ri-Li: Institute of High Altitude Medicine, Qinghai Medical College, 16 Kunlun Road, Xining, Qinghai 180001, China.

Mr. Chase, Ms. Witkowski, Ms. Wyrick, and Drs. Stone, Levine, and Babb: Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, 7232 Greenville Avenue, Suite 435, Dallas, TX 75231.

Author Contributions: Conception and design: G. Ri-Li, B.D. Levine, T.G. Babb.

Analysis and interpretation of the data: G. Ri-Li, B.D. Levine, T.G. Babb.

Drafting of the article: G. Ri-Li, T.G. Babb.

Critical revision of the article for important intellectual content: B.D. Levine, T.G. Babb.

Final approval of the article: B.D. Levine, T.G. Babb.

Provision of study materials or patients: B.L. Wyrick, J.A. Stone, B.D. Levine, T.G. Babb.

Statistical expertise: B.D. Levine, T.G. Babb.

Obtaining of funding: G. Ri-Li, B.D. Levine, T.G. Babb.

Administrative, technical, or logistic support: P.J. Chase, S. Witkowski, J.A. Stone, B.D. Levine, T.G. Babb.

Collection and assembly of data: P.J. Chase, S. Witkowski, B.D. Levine, T.G. Babb.


Ann Intern Med. 2003;139(4):253-257. doi:10.7326/0003-4819-139-4-200308190-00007
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Our principal finding was that obese participants have higher AMS scores than nonobese participants during a 24-hour exposure to simulated altitude of 3658 m. Thus, obesity seems to be associated with the development of AMS. Also, the response of Sao2 with exposure differed between nonobese and obese men; obese men had lower values than nonobese men. These findings suggest that impaired breathing during sleep may be an important pathophysiologic mechanism for the increased levels of AMS in obese individuals.

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Figures

Grahic Jump Location
Figure 1.
Comparison of the acute mountain sickness (AMS) score at sea level and at simulated altitude for 24 hours in nonobese (n= 10) and obese (n= 8) participants.P

Data are displayed as boxplots, which indicate the distribution of AMS scores within each group. The bottom of the box represents the lower 25th quartile of scores, and the top of the box represents the 75th quartile of scores. The dashed line represents the median. The vertical lines show the largest or lowest value observed outside the box. The black circle shows the position of extreme outlier. The interaction between AMS score and group with exposure was significant ( < 0.001).

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Grahic Jump Location
Figure 2.
Comparison of Sao 2 at sea level, during the daytime, and during sleep at night in nonobese (n= 10) and obese (n= 8) participants.o2P

Data are displayed as boxplots, which indicate the distribution of acute mountain sickness scores within each group. The bottom of the box represents the lower 25th quartile of scores, and the top of the box represents the 75th quartile of scores. The dashed line represents the median. The vertical lines show the largest or lowest value observed outside the box. Black circles show the position of extreme outliers. The interaction between Sa values with exposure and group was significant ( < 0.001).

Grahic Jump Location
Grahic Jump Location
Figure 3.
Participants during simulated altitude exposure in decompression chamber.
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Summary for Patients

Obesity and Acute Mountain Sickness

The summary below is from the full report titled “Obesity: Associations with Acute Mountain Sickness.” It is in the 19 August 2003 issue of Annals of Internal Medicine (volume 139, pages 253-257). The authors are G. Ri-Li, P.J. Chase, S. Witkowski, B.L. Wyrick, J.A. Stone, B.D. Levine, and T.G. Babb.

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