Adaptation, Aging and Disease Epidemiology in High Altitude Population of Ladakh

Abstract

While altitude acclimatization refers to the physiological responses that takes place on ascending to hypobaric hypoxic high altitude environment; adaptation is both genetic and non-genetic, consisting of physiological, biochemical or behavioral adjustments. Average hemoglobin of 17.46 (±2.18) g/dl and SpO2 84 % (±9.5 %) found in natives of korzok (4550 m) is a well known response to low oxygen saturation. However a substantially higher value of FEVI/FVC and MMEF in these highlanders was a surprise finding. About 2% of korzok men develop chronic mountain sickness at about 48 years, a condition of accelerated ageing due to decreasing hypoventilatory drive following prolonged stay at altitude. CAVI shows extreme increase with age in some high altitude natives. Changing disease ecology comparing contemporary scenario with historical perspective indicates a marked rural- urban distinction. Nutritional factor, poor food and water hygiene, poor health care facilities, high risk diet, environmental dust and domestic fire pollution are responsible for high prevalence of upper GI and hepatobiliary cancers and poor respiratory health in rural population. Obesity, diabetes, coronary heart disease and vehicular accidents are the main disease burden in the urban population. High prevalence of HBV carriers (8%) in rural population and H. pylori acquisition in (95% of population) resulting in high prevalence of chronic liver disease, liver cancers and cancer of the stomach are cause of concern in the contemporary disease epidemiology.