title: [High altitude anemia: validity of definition criteria].
abstract: The effect of iron and folate supplementation on the hemoglobin response and iron status was studied in male and female equatorian medical students: 66 in Quito (2,800 m altitude) and 40 in Guayaquil (sea level). At the end of the supplementation, there was a nearly complete disappearance of biochemical evidence of iron deficiency in the two groups of students. In Quito, 30% of the men and 26% of the women increased their hemoglobin concentration by more than 1 g/dl after one month of supplementation and could be considered as true anemics, compared to 31% of the men and 29% of the women in Guayaquil. This study shows that at sea level, cut-off points defined by WHO for hemoglobin, taking as reference the impact of a supplementation trial, have a specificity of 100% but poor sensitivity (58%). For people living at high altitudes, cut-off limits adjusted for altitude seem unsuitable: the specificity is 98% but the sensitivity is 0%. Studies taking into account all the factors impacting on the hemoglobin level could be useful for defining cut-off points for high-altitude anemia better than those currently recommended.
authors.affiliation: Laboratorio de Investigaciones de Bioquímica, Facultad de Ciencias Médicas de Quito, Equateur.
authors.forename: R
authors.initials: R
authors.lastname: Yepez
authors.forename: E
authors.initials: E
authors.lastname: Estevez
authors.forename: P
authors.initials: P
authors.lastname: Galan
authors.forename: M
authors.initials: M
authors.lastname: Chauliac
authors.forename: M
authors.initials: M
authors.lastname: Davila
authors.forename: A
authors.initials: A
authors.lastname: Calle
authors.forename: R
authors.initials: R
authors.lastname: Estrella
authors.forename: A M
authors.initials: AM
authors.lastname: Masse-Raimbault
authors.forename: S
authors.initials: S
authors.lastname: Hercberg
mesh_terms: D000328:Adult; D000531:Altitude; D000740:Anemia / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D000747:Anemia, Hypochromic / Q000097:blood* / Q000188:drug therapy* / Q000453:epidemiology; D003937:Diagnosis, Differential; D004484:Ecuador / Q000453:epidemiology; D005069:Evaluation Studies as Topic; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000627:therapeutic use*; D005492:Folic Acid / Q000627:therapeutic use*; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014944:World Health Organization
chemical_list: D005296:Ferrous Compounds; D006454:Hemoglobins; C020748:ferrous sulfate; D005293:Ferritins; D005492:Folic Acid
vernacular_title: Anémie en altitude: validité du critère de définition.