Hyperlipidaemia, lack of sleep and smoking as risk factors for proteinuria among high altitude mountain trekkers.
OBJECTIVE
The number of alpine accidents has been increasing among trekkers in Japan. Some of the alpine accidents have been related to acute mountain sickness (AMS). At present, the mechanism of AMS is poorly clarified, however, it is well known that hypoxia at high altitudes plays an important role. A good relation exists between proteinuria, altitude and hypoxia. However, no reports are available concerned with the risk factors of proteinuria for trekkers at high altitudes.


METHODS
The authors evaluated 41 trekkers and 13 highlanders (cabin employees) through physical examinations and interviews held in a mountain cabin (2300 m above sea level) located in a mountain (2926 m above sea level) in the Japanese Alps. First, urine samples were collected and urinalysis was performed. Second, non-invasive blood pressure, heart rate, and arterial oxygen saturation (SpO2) were measured using a portable life monitor.


RESULTS
Proteinuria was present in 20 (49%) participants. Past history of hyperlipidaemia, amount of sleep, and smoking history are independently associated with proteinuria. Among the physiological examinations conducted at the cabin, only systolic blood pressure demonstrated strong association with proteinuria. Receiver operating characteristic curve analysis using a score combining past history of hyperlipidaemia, amount of sleep and smoking history revealed that the diagnostic accuracy of proteinuria at the cut-off score of 2 was 80%.


CONCLUSIONS
This study indicated that these three variables were significantly and independently correlated with proteinuria: hyperlipidaemia, amount of sleep (night before) and smoking history. Improvement of these three variables might decrease the risk of alpine accidents including AMS.
Wada
Kentaro
K
Department of Internal Medicine, Social Insurance Central General Hospital, Hyakunin-cho, Shinjuku-Ku, Tokyo, Japan. kyw620@theia.ocn.ne.jp
Mizuguchi
Yoshiaki
Y
Wada
Yuko
Y
Ohno
Youkichi
Y
Iino
Yasuhiko
Y