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1 Department of Internal Medicine, University of Berne, and 4 Institute for Chemical Pathology, Inselspital, CH-3010 Berne; and 2 Kantonsspital, CH-8401 Winterthur, Switzerland; 3 Department of Surgery, State University of New York at Stony Brook, Stony Brook, New York 11794-8191; and 5 Department of Sports Medicine, University of Heidelberg, D-69115 Heidelberg, Germany
The acute effects of active and passive ascent to high altitude on
plasma volume (PV) and rates of synthesis of albumin and fibrinogen
have been examined. Measurements were made in two groups of healthy
volunteers, initially at low altitude (550 m) and again on the day
after ascent to high altitude (4,559 m). One group ascended by
helicopter (air group, n = 8), whereas the other group climbed (foot group, n = 9), so that the separate
contribution of physical exertion to the response could be delineated.
PV was measured by dilution of 125I-labeled albumin,
whereas synthesis rates of albumin and fibrinogen were determined from
the incorporation of isotope into protein after injection of
[ring-2H5]phenylalanine. In the
air group, there was no change in PV at high altitude, whereas, in the
foot group, there was a 10% increase in PV (P < 0.01). Albumin synthesis
(mg · kg
1 · day1) increased
by 13% in the air group (P = 0.058) and by 32% in the
foot group (P < 0.001). Fibrinogen synthesis
(mg · kg1 · day1) increased
by 40% in the air group (P = 0.068) and by 100% in the foot group (P < 0.001). Hypoxia and alkalosis at
high altitude did not differ between the groups. Plasma interleukin-6
was increased modestly in both groups but C-reactive protein
was not changed in either group. It is concluded that increases in PV
and plasma protein synthesis at high altitude result mainly from the
physical exercise associated with climbing. However, a small
stimulation of albumin and fibrinogen synthesis may be attributable to
hypobaric hypoxia alone.
exercise; hypobaric hypoxia; respiratory alkalosis; plasma volume; inflammation
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