格日力, 吴德, 杨辉惶, 刘义宁, 王秀娟, 陶倪
青海大学高原医学研究中心，西宁810001； 青藏铁路公司第五局医院，格尔木 816000；美国德州大学西南医学中心 环境与运动医学研究所，达拉斯 75231-5129，美国
平原人暴露于海拔3 500 m 以上高原，特别是急进高原之后存在体重下降现象，但其体重下降程度与高原反应相关 关系目前未见报道。本研究选择修建青藏铁路可可西里昆仑山口区的120 名男性铁路建设者为研究对象，全体受检者居住环 境、进食以及劳动强度等条件基本相当，其中85 名来自平原地区(平原组)，35 名来自青海东部农业区(中海拔组；海拔2 200 m)。受检者乘火车到格尔木地区(海拔2 800 m)，并在此停留7 d，测定体重、体重指数、腰围等指标，之后乘车到昆仑山口 (海拔4 678 m)工作33 d 后再次测定以上各指标。到达昆仑山口2 d 后，采用Lake Louise 急性高原病(acute mountain sickness, AMS)评分规则对平原组和高原组进行评分。为了动态观察体重的日变化，对来自平原组的20 名施工人员，每天早上施工之 前测体重，连续测量33 d。结果显示，平原组在格尔木和昆仑山所测平均体重分别为(67.1±9.5) kg 和(60.0±8.1) kg (P<0.01)， 中海拔组体重分别为(63.1±5.5) kg 和(61.7±6.4) kg (P>0.05)。平原组平均体重降低幅度为10.4% (范围6.5%~29%)，而中海拔组 为2.2% (范围-2%~9.1%)。平原组体重下降的程度与暴露高原之前的体重(基础值)呈显著正相关(r=0.677, P<0.01)，而中海拔 组体重下降程度与基础体重不相关(r=0.296, P>0.05)。20 名平原人到达高原20 d 内体重降低最明显，之后体重基本保持不变。 平原组AMS 评分(4.69±2.48)显著高于中海拔组(2.97±1.38)，两组AMS 评分与基础体重值呈正相关(r=0.643, P<0.01)。以上结 果提示：(1)平原人暴露高原环境之后体重显著减轻，体重越高者体重减轻程度越高；(2)较高体重指数的平原人快速进入高原 之后，易出现急性高原反应，甚至发生AMS。
The body weight loss during acute exposure to high-altitude hypoxia in sea level residents
GERi-Li, Wood Helen, YANG Hui-Huang, LIU Yi-Ning, WANG Xiu-Juan, Babb Tony
Research Center for High Altitude Medicine, Qinghai University, Xining 810001, China； The Hospital of the 5th Railway Engineering Group at the Golmud-Lhasa Railway, Golmud 816000, China； Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas and University of Texas Southwestern Medical Center-Dallas, Dallas 75231-5129, TX, USA
Weight loss is frequently observed after acute exposure to high altitude. However, the magnitude and rate of weight loss during acute exposure to high altitude has not been clarified in a controlled prospective study. The present study was performed to evaluate weight loss at high altitude. A group of 120 male subjects [aged (32±6) years] who worked on the construction of the Golmud- Lhasa Railway at Kunlun Mountain (altitude of 4 678 m) served as volunteer subjects for this study. Eighty-five workers normally resided at sea level (sea level group) and 35 normally resided at an altitude of 2 200 m (moderate altitude group). Body weight, body mass index (BMI), and waist circumference were measured in all subjects after a 7-day stay at Golmud (altitude of 2 800 m, baseline measurements). Measurements were repeated after 33-day working on Kunlun Mountain. In order to examine the daily rate of weight loss at high altitude, body weight was measured in 20 subjects from the sea level group (sea level subset group) each morning before breakfast for 33 d at Kunlun Mountain. According to guidelines established by the Lake Louise acute mountain sickness (AMS) consensus report, each subject completed an AMS self-report questionnaire two days after arriving at Kunlun Mountain. After 33-day stay at an altitude of 4 678 m, the average weight loss for the sea level group was 10.4% (range 6.5% to 29%), while the average for the moderate altitude group was 2.2% (-2% to 9.1%). The degree of weight loss ( weight loss) after a 33-day stay at an altitude of 4 678 m was significantly correlated with baseline body weight in the sea level group (r=0.677, P<0.01), while the correlation was absent in the moderate altitude group (r=0.296, P>0.05). In the sea level subset group, a significant weight loss was observed within 20 d, but the weight remained stable thereafter. AMS-score at high altitude was significantly higher in the sea level group (4.69±2.48) than that in the moderate altitude group (2.97±1.38), and was significantly correlated with baseline body weight. These results indicate that (1) the person with higher body weight during stay at high altitude loses more weight, and this is more pronounced in sea level natives when compared with that in moderate altitude natives; (2) heavier individuals are more likely to develop AMS than leaner individuals during exposure to high-altitude hypoxia.
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格日力, 吴德, 杨辉惶, 刘义宁, 王秀娟, 陶倪. 平原人急进暴露高海拔地区导致体重下降[J]. 生理学报 2010; 62 (6): 541-546.
GERi-Li, Wood Helen, YANG Hui-Huang, LIU Yi-Ning, WANG Xiu-Juan, Babb Tony. The body weight loss during acute exposure to high-altitude hypoxia in sea level residents. Acta Physiol Sin 2010; 62 (6): 541-546 (in Chinese with English abstract).