Larger FVC and FEV1 among Tibetans compared to Han born and raised at high altitude.

OBJECTIVES: This study compares forced vital capacity (FVC) and Forced Expiratory Volume at 1 Second (FEV1 ) of Tibetans with those of Han who were born and raised at high altitude. MATERIALS AND METHODS: FVC and FEV1 tests were conducted among 1,063 children and adolescents between the ages of 6 and 20 years, and 184 adults between the ages of 21 and 39 years who had lived their entire lives at 3200 m, 3800 m and 4300 m in Qinghai Provence, Peoples Republic of China. RESULTS: Even though FVC and FEV1 values of Han born and raised at high altitude are generally lower than those of Tibetans through age 15 in girls and age 16 in boys, differences are largely explained by variation in stature (height-squared) and chest circumference. Among older adolescents and adults, the FVC and FEV1 values of Tibetans are significantly larger than those of Han born and raised at high altitude; and are much larger than would be predicted, based on stature and chest circumference. DISCUSSION: These results indicate that the large FVC and FEV1 values of Tibetan adults develop primarily from an accelerated pattern of lung growth that begins during mid-to-late adolescence and possibly extends into young adulthood. This developmental pattern is not only distinct from that of Han born and raised at high altitude, but also from those of Andean Quechua and Aymara. The pace of lung function growth may therefore represent another feature distinguishing the Tibetan from the Andean pattern of adaptation to high altitude hypoxia. Because of this, a search for features in the Tibetan genome related to this lung function growth phenotype might be productive and important.

Responses of Han migrants compared to Tibetans at high altitude.

While many studies have compared Tibetans and low-altitude born Han living at high altitude, few have carefully controlled the chronological age at which lowlanders migrated, the length of time they had lived at high altitude, their nutrition, and their socio-economic status. This has produced an array of results that frequently do not support the hypothesis that Tibetans and Han show fundamental differences in their response to hypoxia. Unlike the situation in the Andes, only one study has tested the developmental adaptation hypothesis on the Qinghai-Tibetan plateau. This study shows that Tibetans and Han of the same age, who were born and raised in the same towns at the same altitudes, show considerable overlap in the individual distribution of [Hb], SaO2 and lung volumes. These results indicate that second-generation Han make substantial developmental adjustments to hypoxia that are not reflected in studies of first-generation migrants. Thus, there is a great need for further developmental studies to determine whether and/or how Han and Tibetan responses to hypoxia diverge, as well as for studies exploring whether Han and Tibetans who show similar responses also share genetic adaptations.

Morphological growth and thorax dimensions among Tibetan compared to Han children, adolescents and young adults born and raised at high altitude.

BACKGROUND: Studies comparing the growth of indigenous high-altitude Aymara children and children of low-altitude European descent who have been born and raised at high altitude in the Andes have provided evidence for genetically-determined differences in thorax growth, as well as for population differences in height, weight and other measures of overall size. Comparable studies now can be undertaken in Asia because of the growing number of Han Chinese who have been born and raised at high altitude on the Qinghai-Tibetan Plateau. AIM: The study compares the growth of indigenous Tibetan children and children of Han descent who have been born and raised at the same high altitudes, and under similar socio-economic conditions. SUBJECTS AND METHODS: Measurements of stature, sitting height, weight, triceps and subscapular skinfolds, upper arm muscle area, transverse chest diameter, anterio-posterior chest diameter, and chest circumference were taken on 1439 Tibetan and Han males and females between the ages of 6 and 29 years who were born and raised 3200 m, 3800 m or at 4300 m in the high altitude province of Qinghai in western China. RESULTS: Han-Tibetan differences in body size do not occur systematically for any measurement, for any age group, or for either gender; nor is there a systematic pattern of body size differences between 3200 m and 4300 m. This indicates that there are no differences in general growth between the two groups at high altitude in Qinghai, although both groups grow more slowly than urban children at low altitude in China. On the other hand, Tibetan males possess significantly deeper chests than Han males, and Tibetan females possess significantly wider chests than Han females. Tibetans of both sexes possess significantly larger chest circumferences than Han males and females. CONCLUSIONS: Although genetic similarities cannot be ruled out, comparable dietary stress is a likely explanation for the similar and slow morphological growth of Han and Tibetans at high altitude. However, Han-Tibetan differences in thorax dimensions are likely a consequence of population (genetic) differences in the response to hypoxia during growth.

Hematological differences during growth among Tibetans and Han Chinese born and raised at high altitude in Qinghai, China.

This study describes the hemoglobin concentration ([Hb]) and hematocrit (HCT) of over 1,000 Tibetan and Han children, adolescents, and young adults who were born and raised at 3,200 m, 3,800 m, or 4,300 m in Qinghai Province, western China. At 3,200 m, no altitude effect is evident in the hematological characteristics of either group. At 3,800 m and 4,300 m, both groups show [Hb] and HCT values that are above low-altitude norms. At both altitudes, Tibetan and Han children show no differences in the pattern of hematological response up to age 13. Among adolescents and young adults, however, the [Hb] and HCT of Han males and females are elevated compared to Tibetans. This indicates that the adolescent period may involve a divergence in the responses to hypoxia made by some individuals in these two groups. Also, many other adolescents and young adults in both groups show similar hematological characteristics, indicating that many Tibetans and Han share similar hematological responses to hypoxia.

Lung function of Han Chinese born and raised near sea level and at high altitude in Western China.

Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV(1)), and FEV(1)/FVC ratios were determined for 531 individuals of Han Chinese descent living at low altitude (250 m) near Beijing and for 592 individuals of Han descent who were born and raised at three high altitudes (3,200 m, 3,800 m, 4,300 m) in Qinghai Province, P.R.C. The study included males and females, ages 6-51 years. Thorax widths, depths, and circumferences of Han females and males born and raised at high altitude are similar to those of low-altitude Han. On the other hand, high-altitude children and adolescents have larger relative sitting heights, indicating greater thorax lengths. After adjusting for this variation in morphology, mean FVC values among 6-21 year-old Han at high altitude are only between 136 mL (for females) and 173 ml (for males) greater than those determined at low altitude but the differences are statistically significant and are maintained consistently throughout the growth period. These data indicate that growth at high altitude produces small-to-moderate increases in lung volumes (about 6%) relative to genetically similar groups growing up at low altitude. In addition, there is no evidence that lung volume growth is accelerated relative to morphological growth among Han children born and raised at high altitude. Adults, 22-51 years, also show greater FVC values at high altitude but the size of the increase relative to Han at low altitude is variable (3% in males and 11% in females). Greater lung function at high altitude is unlikely to result from increased activity or lower pollution, and thus appears to be primarily a result of development in a hypoxic environment. Differences in FVC and FEV(1) at 3,200 m, 3,800 m, and 4,300 m are generally not significant, so that living at altitudes between 3,200 m and 4,300 m appears to have little additional effect on volumetric growth.

Morphological growth of Han boys and girls born and raised near sea level and at high altitude in western China.

This study compares the morphological characteristics of Han children, adolescents, and young adults who were born at 250 m near Beijing and at three high altitudes in Qinghai Province, Peoples Republic of China (3,200 m, 3,800 m, and 4,300 m). From ages 6 through 15, Han children growing up at high altitudes are significantly shorter, lighter, have less fat, and are less muscular than Han children growing up at low altitude. However, older adolescents and young adults show no such altitude differences. Younger adolescents and children in this study were all born after the government economic reforms of 1978. These reforms had a greater impact on the growth of children in and around large cities than on those in more remote areas. Therefore, the altitude differences in size among Han children ages 15 and younger may be a consequence of regional variation in health and nutrition, rather than due to the influence of hypoxia. There are no altitude-related differences in thorax dimensions among Han children, adolescents, or young adults. This suggests that hypoxia does not affect the thorax growth of Han children. Am. J. Hum. Biol. 12:665-681, 2000. Copyright 2000 Wiley-Liss, Inc.