The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study
Abstract Cerebral small vessel disease (CSVD) is a major neurovascular contributor to stroke and cognitive impairment, yet its interaction with chronic high-altitude adaptation remains poorly understood. This first neuroimaging investigation examined 499 Tibetan natives residing at 2000–4800 m using...
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Nature Portfolio
2025-07-01
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| author | Shaoli Yao Zhen-rong Qi Shi-min Bao Yi-yin Xing Hui-ru Feng Yuling Tan Qi Zhang Wei-hong Ge Xiaorong Chen |
| author_facet | Shaoli Yao Zhen-rong Qi Shi-min Bao Yi-yin Xing Hui-ru Feng Yuling Tan Qi Zhang Wei-hong Ge Xiaorong Chen |
| author_sort | Shaoli Yao |
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| description | Abstract Cerebral small vessel disease (CSVD) is a major neurovascular contributor to stroke and cognitive impairment, yet its interaction with chronic high-altitude adaptation remains poorly understood. This first neuroimaging investigation examined 499 Tibetan natives residing at 2000–4800 m using 3 T MRI to quantify CSVD burden and to assess its association with residential altitude. Multivariable logistic regression, treating altitude as both a continuous variable (per 500 m increment) and a categorical variable (mid-high [2000–3500 m] vs. ultra-high [> 3500 m]), revealed that 51.5% of participants had CSVD (CSVD score ≥ 1), with adjusted odds ratios of 0.94 (95% CI: 0.74–1.21) per 500 m altitude and 0.78 (95% CI: 0.42–1.44) for ultra-high versus mid-high altitude. Partial proportional odds model showed no significant association between altitude and CSVD score (OR = 1.18, 95% CI 0.99–1.40). These null findings, in contrast to the well-established paradoxical impact of altitude on stroke risk, suggest potential neuroprotective mechanisms in altitude-adapted populations. Our results challenge conventional cerebrovascular paradigms and highlight the need for further research into Tibetan-specific genetic adaptations that may modulate CSVD pathophysiology. This study provides essential insights for refining altitude-related cerebrovascular risk models. |
| format | Article |
| id | doaj-art-671d9f8c60ca4a0dbc09eac8d8836dd0 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-671d9f8c60ca4a0dbc09eac8d8836dd02025-08-20T04:01:23ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-09891-2The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional studyShaoli Yao0Zhen-rong Qi1Shi-min Bao2Yi-yin Xing3Hui-ru Feng4Yuling Tan5Qi Zhang6Wei-hong Ge7Xiaorong Chen8Department of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionDepartment of Neurology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous RegionAbstract Cerebral small vessel disease (CSVD) is a major neurovascular contributor to stroke and cognitive impairment, yet its interaction with chronic high-altitude adaptation remains poorly understood. This first neuroimaging investigation examined 499 Tibetan natives residing at 2000–4800 m using 3 T MRI to quantify CSVD burden and to assess its association with residential altitude. Multivariable logistic regression, treating altitude as both a continuous variable (per 500 m increment) and a categorical variable (mid-high [2000–3500 m] vs. ultra-high [> 3500 m]), revealed that 51.5% of participants had CSVD (CSVD score ≥ 1), with adjusted odds ratios of 0.94 (95% CI: 0.74–1.21) per 500 m altitude and 0.78 (95% CI: 0.42–1.44) for ultra-high versus mid-high altitude. Partial proportional odds model showed no significant association between altitude and CSVD score (OR = 1.18, 95% CI 0.99–1.40). These null findings, in contrast to the well-established paradoxical impact of altitude on stroke risk, suggest potential neuroprotective mechanisms in altitude-adapted populations. Our results challenge conventional cerebrovascular paradigms and highlight the need for further research into Tibetan-specific genetic adaptations that may modulate CSVD pathophysiology. This study provides essential insights for refining altitude-related cerebrovascular risk models.https://doi.org/10.1038/s41598-025-09891-2CSVD burdenAltitudeTibetan PlateauObservational studyMRI biomarkersHigh-altitude adaptation |
| spellingShingle | Shaoli Yao Zhen-rong Qi Shi-min Bao Yi-yin Xing Hui-ru Feng Yuling Tan Qi Zhang Wei-hong Ge Xiaorong Chen The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study Scientific Reports CSVD burden Altitude Tibetan Plateau Observational study MRI biomarkers High-altitude adaptation |
| title | The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study |
| title_full | The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study |
| title_fullStr | The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study |
| title_full_unstemmed | The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study |
| title_short | The association between altitude and cerebral small vessel disease burden in the Tibetan population: a cross-sectional study |
| title_sort | association between altitude and cerebral small vessel disease burden in the tibetan population a cross sectional study |
| topic | CSVD burden Altitude Tibetan Plateau Observational study MRI biomarkers High-altitude adaptation |
| url | https://doi.org/10.1038/s41598-025-09891-2 |
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