Maternal plasma glucose at high altitude

Krampl, Elisabeth; Kametas, Nikos; Zegarra, Ana Maria Cacho; Roden, Michael; Nicolaides, Kypros H.

doi:10.1016/s0306-5456(00)00072-3

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…These types of studies would have the advantage of more explicit glucose measurements than the nonfasting oral glucose challenge test used for GDM diagnosis and possibility to determine insulin resistance. If no difference in these parameters between altitude groups emerged, then the previously observed alterations in glucose metabolism and insulin sensitivity during pregnancy (Krampl et al, 2001a(Krampl et al, , 2001b would seem to be a specific adaptation to populations who have resided at HA for multiple generations.…”

Section: Resultsmentioning

confidence: 98%

“…Prior studies of the effect of altitude on glucose metabolism have been conducted in populations that have lived at HA for millennia such as Bolivia and Peru (Krampl et al, 2001a(Krampl et al, , 2001bCastillo et al, 2007;Zamudio et al, 2010), and have undergone natural selection for genetic traits that may affect aspects of glucose metabolism (Bigham et al, 2014;Moore, 2017). In these South American populations, multiple elements of glucose metabolism, including fasting (Krampl et al, 2001a(Krampl et al, , 2001bCastillo et al, 2007) and postprandial (Castillo et al, 2007) glucose levels, arterial-venous glucose differential (Zamudio et al, 2010), and insulin sensitivity (Krampl et al, 2001b), have been shown to be affected by the altitude of residence. While populations have lived consistently at HA in Colorado for at least 200 years, it is unlikely that our cohort was enriched in multigenerational HA families or had the same, protective genetic traits as present in South American HA populations.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to possible genetic differences between highaltitude populations in North and South America, it is also possible that there was no difference in GDM prevalence because the altitude difference was not great enough between our MA and HA groups. The previous HA glucose studies in Peru and Bolivia were conducted at >14,000 and 12,000 ft, respectively, versus sea level (Krampl et al, 2001a(Krampl et al, , 2001bCastillo et al, 2007;Zamudio et al, 2010), and hence across a greater altitude gradient than available in Colorado. However, in this study, we did see differences in our HA cohort, particularly a higher third trimester hemoglobin concentration, suggesting that the difference in altitudes was sufficient to cause physiologic effects.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to glucose metabolism, prior studies have shown that male and nonpregnant female HA residents had lower fasting glucose levels, improved glucose tolerance, and decreased postprandial glucose elevation (Braun et al, 1998;Krampl et al, 2001a;Castillo et al, 2007). In pregnancy, fasting plasma glucose levels at HA were decreased compared to women at sea level and decreased further with advancing gestational age (GA) (Krampl et al, 2001a(Krampl et al, , 2001b. Also, there is a higher insulin sensitivity in pregnancy at HA (Krampl et al, 2001b).…”

Section: Introductionmentioning

confidence: 99%

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Gestational Diabetes Prevalence at Moderate and High Altitude

Euser

Hammes

Ahrendsen

et al. 2018

High Altitude Medicine & Biology

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Background: High-altitude (HA) pregnancies have been associated with decreased glucose levels and increased insulin sensitivity versus sea level. Our objective was to determine if the prevalence of gestational diabetes mellitus (GDM) and the impact of demographic characteristics on GDM diagnosis differed at moderate altitude (MA) versus HA. Methods: Using a retrospective cohort design, we compared women living at HA (>8250 ft) and MA (4000-7000 ft) during pregnancy. Exclusion criteria were as follows: multiple gestation, preexisting diabetes, unavailable GDM results, or relocation from a different altitude during pregnancy. GDM diagnosis was determined using Carpenter and Coustan criteria. Data were compared by t-test (continuous variables) or chi-squared tests (categorical variables). Univariate, multivariate, and stepwise regression models were used to assess the impact of various factors on GDM prevalence. Results: There was no difference in GDM prevalence between altitudes in these populations; the relationship between altitude and GDM was nonsignificant in all regression analyses. At MA, maternal age, Hispanic ethnicity, body mass index (BMI), and gestational age (GA) at testing increased GDM incidence in univariate analyses. At HA, maternal age, Hispanic ethnicity, and multiparity increased GDM incidence in univariate analyses. Conclusion: While GDM prevalence did not differ between MA and HA, the impact of maternal demographic characteristics on GDM risk varied by altitude group. Higher BMI and greater GA at testing increased the incidence of GDM at MA, but not at HA. Multiparity had an effect at HA, but not MA. These differences may represent subtle differences in glucose metabolism at HA.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gestational Diabetes Prevalence at Moderate and High Altitude

Euser

Hammes

Ahrendsen

et al. 2018

High Altitude Medicine & Biology

View full text Add to dashboard Cite

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“…6 Fasting plasma glucose is lower in pregnant women than nonpregnant women, possibly as a result of haemodilution. 8 In a Caucasian population in Austria, fasting plasma glucose of 78 AE 1.7 mg/dl was found in pregnant women without GDM as compared to 84 AE 1.9 mg/dl in those with GDM. 2 Also, a Dutch multiethnic cohort study found fasting plasma glucose of 3.6 AE 0.4 mmol/l for normal pregnant women and 4.7 AE 0.7 mmol/l for women with GDM.…”

Section: Introductionmentioning

confidence: 96%

Response to fifty grams oral glucose challenge test and pattern of preceding fasting plasma glucose in normal pregnant Nigerians

Adegbola

Ajayi

2014

Obstet Med

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The mean fasting plasma glucose in normal pregnant Nigerians was 74.5 ± 11.5 mg/dl (range 42 to 117 mg/dl). There is a need to re-appraise and possibly review downwards the World Health Organization fasting plasma glucose diagnostic criteria in pregnant Nigerians for better detection of gestational diabetes mellitus. Pregnant women with venous plasma glucose greater than 153.5 mg/dl (8.5 mmol/l) 1 hour after 50 g glucose challenge test are strongly recommended for diagnostic test of gestational diabetes mellitus.

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Inverse association between diabetes and altitude: A cross‐sectional study in the adult population of the United States

Woolcott

Castillo

Gutiérrez

et al. 2014

Obesity

106

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ObjectiveTo determine whether geographical elevation is inversely associated with diabetes, while adjusting for multiple risk factors.Design and MethodsThis is a cross-sectional analysis of publicly available online data from the Behavioral Risk Factor Surveillance System, 2009. Final dataset included 285,196 US adult subjects. Odds ratios were obtained from multilevel mixed-effects logistic regression analysis.ResultsAmong US adults (≥20 years old), the odds ratio for diabetes were 1.00 between 0−499 m of altitude (reference), 0.95 (95% confidence interval, 0.90 to 1.01) between 500−1,499 m, and 0.88 (0.81 to 0.96) between 1,500−3,500 m, adjusting for age, sex, body mass index, ethnicity, self-reported fruit and vegetable consumption, self-reported physical activity, current smoking status, level of education, income, health status, employment status, and county-level information on migration rate, urbanization, and latitude. The inverse association between altitude and diabetes in the US was found among men [0.84 (0.76 to 0.94)], but not women [1.09 (0.97 to 1.22)].ConclusionsAmong US adults, living at high altitude (1,500−3,500 m) is associated with lower odds of having diabetes than living between 0−499 m, while adjusting for multiple risk factors. Our findings suggest that geographical elevation may be an important factor linked to diabetes.

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Maternal plasma glucose at high altitude

Cited by 14 publications

References 28 publications

Gestational Diabetes Prevalence at Moderate and High Altitude

Gestational Diabetes Prevalence at Moderate and High Altitude

Response to fifty grams oral glucose challenge test and pattern of preceding fasting plasma glucose in normal pregnant Nigerians

Inverse association between diabetes and altitude: A cross‐sectional study in the adult population of the United States

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