Serum ferritin and vitamin D evaluation in response to high altitude comparing Italians trekkers vs Nepalese porters

Abstract

Altitude hypoxia induces changes in iron homeostasis with serum ferritin (sFER) response being recently linked to erythropoiesis. The main aim of this study was to investigate sFER and Vitamin D (Vit D) response to hypobaric hypoxia, taking into account factors including nutrition and ethnic origin. As part of a “Kanchenjunga Exploration & Physiology” project, 6 Italian trekkers and 6 Nepalese porters took part in a 19-days long altitude trek in the Himalayas self-recording daily food consumption. Blood samples were collected and analyzed before and after the trek for sFER and Vit D. A web-based system calculated the dietary intake, generating reports that were used for later statistical analyses. sFER decreased after the trek (on average by 26% p = 0.013, partial η² = 0.479) in both groups, whereas Vit D did not change in both groups. Nepalese tended to have lower sFER, but this difference was reduced when corrected for the dietary intake. Mean Cell Volume (MCV) and Hematocrit (HCT), in respect to baseline, remained higher 10 days after the trek (respectively, 87.37–88.85 fL with p = 0.044, and 43.05–44.63% with p = 0.065) in Italian trekkers. The observed reduction of sFER levels was related to altitude per se as inflammation or anemia were medically excluded. sFER, therefore, may act as a primary factor in the examination of hypobaric hypoxia in field studies. The results of this study open a new door into the mechanisms of iron homeostasis in specific tissues related to hypoxia adaptations, taking into account dietary intake and ethnic origin.

Keywords:

• Iron status
• hypobaric hypoxia
• Himalayas
• homeostasis
• dietary intake

Acknowledgments

Authors thank the Laboratory of Clinical Pathology of Teramo Hospital, Mission Nepal Holidays Pvt. Ltd (Kathmandu, Nepal), Bir Hospital (Kathmandu, Nepal), all the Italian trekkers and Nepalese porters involved in this project. Conceptualization: LM, DB, VV; methodology: LM, DB, TP, SF, RP, TJ, GDB, MT, VV; formal analysis: LM, DB, RP; investigation: DB, GDB, MT, VV; resources: DB, RP, GDB, MT, VV; writing – original draft: LM, DB, TP, SF, VV; writing – review & editing: LM, DB, TP, SF, RP, TJ, GDB, MT, VV; visualization: LM, DB, TJ; supervision: TP, SF, VV; project administration: VV; funding acquisition: VV.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by a grant of Department of Psychological, Health and Territorial Sciences, “G. d’Annunzio” University of Chieti-Pescara, Italy, to VV.