Effect of Altitude on Hemoglobin and Red Blood Cell Indices in Adults in Different Region of India

Abstract

One frequently used blood test for health checkups is the complete blood count (CBC). This study compared CBC from populations living at sea level and from two different elevations in an effort to propose a correction factor for the elevation of the hemoglobin and red blood cell indices that is related to altitude. Large datasets of CBCs over a 5-year period were screened for this retrospective lab records study from three different localities of India: the coastal city of Gujarat which is located at 1117 meter above sea level, the city of Kasauli, which is located at 1800 meters above sea level; and the city of Chamoli, which is located at 2270 meters above sea level. The CBC variables were compared using descriptive analysis and significance testing at various altitudes. In the end, 57,059 participants were taken into account for the analysis. At sea level, the mean hemoglobin (Hb) concentration (g/dL) for men and women was 14.81 and 13.77, respectively, while in Kasauli City, the Hb concentrations for men and women were 15.35 and 14.19, respectively. However 15.40 and 14.71in Chamoli City, for men and women, respectively. With the exception of mean corpuscular volume (MCV), hemoglobin and other red cell indices varied significantly between men and women at different altitudes. When comparing the MCV 95th percentile range to the present reference range, it was lower at both elevations and sea level (76–91 fLvs 81–98 fL). While there was a discernible increase in Hb concentration with altitude in both genders, it was not as high as recommended by the World Health Organization and the Centers for Disease Control. Additionally, new CBC reference intervals for India citizens residing at high altitudes can be derived from the study's results. In the adult population residing at high altitudes in India, a correction factor (ΔHb) of 0.30 g/dL per 1000 m altitude is recommended to be employed. This should assist characterize anemia and polycythemia at altitude more precisely.