This is the first study to investigate a South American population for genetic polymorphism in the CYP2C subfamily. The Bolivian population differs from most other ethnic groups in the incidence of CYP2C9 and CYP2C19 common variants that might be influenced by its admixture characteristics.
Physiological adaptation to high-altitude living in native Andeans is unlikely to compensate for the significant differences we observed between diurnal and nocturnal oxyhemoglobin saturation, most marked in infancy. This vulnerability to sleep-related hypoxia in early childhood has potential lifespan implications. Future studies should characterize the sleep- related respiratory physiology underpinning our observations.
This is the first study of HA residence and neurocognition across the life span. Given the physiological challenges of HA living, the impact on cognition appears to be subtle and related only to the speed of more complex cognitive operations, rather than to their accuracy. Moreover, the impact on cognition does not appear to differ with increasing age or for different degrees of genetic admixture. Further studies recruiting HA participants with a broader range of native Andean ancestry will help to address the issue of to what extent Amerindian ancestry provides neuroprotection to chronic hypoxia in those living at HA.
HA native Andean children have more respiratory events when scoring relies on SpO2 desaturation due to inherent SpO2 instability. Use of American Academy of Sleep Medicine scoring criteria may yield false-positive results for obstructive sleep-disordered breathing at HA.
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