ArticleBMC public health2014
Chronic mountain sickness in Chinese Han males who migrated to the Qinghai-Tibetan plateau: application and evaluation of diagnostic criteria for chronic mountain sickness.
Article in BMC public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Mountain sickness in altitude inhabitants of Latin America: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Safety and Efficacy of Therapeutic Erythrocytapheresis Treatment in Chronic Mountain Sickness Patients in Shigatse, Tibet, China.Medical science monitor : international medical journal of experimental and clinical research · 2020Trial
- Chronic high-altitude exposure and intracerebral hemorrhage: A novel perspective from the vascular-immune-neuronal network.Neuroprotection (Chichester, England) · 2026Review
- Olink Proteomics Reveals CCL2 Aggravates Perihematomal Edema After Intracerebral Hemorrhage in High-Altitude Migrants Via CCR2/NF-κB-Mediated Blood-Brain Barrier Disruption.CNS neuroscience & therapeutics · 2026Article
- Mechanisms Underlying Altitude-Induced and Group 3 Pulmonary Hypertension.International journal of molecular sciences · 2026Review
- Hyperviscosity encephalopathy in suspected polycythemia vera at high altitude: a case report.Frontiers in medicine · 2026Article
- Integrated Metabolomic and Transcriptomic Analysis Suggests Potential Therapeutic Mechanism of Shengxian Decoction in Hypobaric Hypoxia-Induced Pulmonary Hypertension in SD Rats.Drug design, development and therapy · 2026Article
- High altitude renal syndrome: four elements or one source?Renal failure · 2025Review
- [Chinese expert consensus on the diagnosis and treatment of high-altitude polycythemia(2025)].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2025Article
- Differences in Pathogenetic Mechanism Between Tibetan and Han High-Altitude Polycythemia Based on a Whole Genome-Wide Association Study.Phenomics (Cham, Switzerland) · 2025Article
- Redefining chronic mountain sickness: insights from high-altitude research and clinical experience.Medical review (2021) · 2025Review
- Life destiny of erythrocyte in high altitude erythrocytosis: mechanisms underlying the progression from physiological (moderate) to pathological (excessive) high-altitude erythrocytosis.Frontiers in genetics · 2025Review
- Hematological characteristics, oxidative stress, and patient-reported symptoms in Tibetan patients with chronic mountain sickness at 4500 m altitude.Frontiers in physiology · 2025Article
- Protocol for evaluating physiological and psychological acclimatization mechanisms in Tibetan plateau environment: a clinical study of doctors from Peking Union Medical College Hospital.Frontiers in public health · 2024Observational
- Investigation on the relationship between hemoglobin concentration and stroke risk: a bidirectional Mendelian randomization study.Frontiers in neurology · 2024Article
- Alteration in the number, morphology, function, and metabolism of erythrocytes in high-altitude polycythemia.Frontiers in physiology · 2024Article
- Structural variants involved in high-altitude adaptation detected using single-molecule long-read sequencing.Nature communications · 2023Article
- The Oxygen Cascade from Atmosphere to Mitochondria as a Tool to Understand the (Mal)adaptation to Hypoxia.International journal of molecular sciences · 2023Review
- High-altitude Hypoxia Influences the Activities of the Drug-Metabolizing Enzyme CYP3A1 and the Pharmacokinetics of Four Cardiovascular System Drugs.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Pulmonary Capacity, Blood Composition and Metabolism among Coal Mine Workers in High- and Low-Altitude Aboveground and Underground Workplaces.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic mountain sickness (CMS), originally characterized by excess hemoglobin (Hb), is currently diagnosed using score-based diagnostic criteria combined with excessive erythrocytosis and clinical symptoms. However, the current criteria have limited applicability. We applied these criteria to 1,029 Chinese Han males migrated to and have been stayed at the Qinghai-Tibet plateau (3,700-5,000 m) for 2-96 months to investigate the prevalence of CMS and its correlations with Hb concentration, altitude, and the length of residence.
methodsSubjects were screened for CMS using the latest approved diagnostic criteria combined with excessive erythrocytosis and clinical symptoms. Hb concentrations were measured, and a cut-off point was determined with k-means clustering. Predisposing factors were evaluated with binary logistic analysis and curve fitting analysis.
results(1) The prevalence of CMS at the Qinghai-Tibetan plateau was 17.8% (183/1029 subjects, with CMS score ≥ 6, and Hb ≥ 210 g/L), which is higher than that previously reported. (2) While individuals were identified into two Hb clusters with a cut-off point of 200 g/L, in the low-Hb cluster (Hb < 200 g/L), the oxygen saturation remained stable as the Hb increased; in the high-Hb cluster (Hb ≥ 200 g/L), the oxygen saturation decreased as the Hb increased. (3) Two critical factors associated with CMS development were residence at an altitude of 4,500 m and a 60-month length of residence.
conclusionsOur presenting scoring system is more sensitive than previous diagnostic criteria and favors early screening and treatment of patients with CMS. Our finding suggests that an adjusted Hb threshold of 200 g/L (instead of 210 g/L) is more adaptable in Han individuals at all altitudes. The weight of Hb level should score ≥ 6 points using the CMS scoring system because of the pathophysiologic role of excessive erythrocytosis in patients with CMS. In addition, our data suggest the importance of early screening of CMS via regular medical examinations within the first 60 months of residence at high altitudes, especially >4500 m.
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