Metabolic basis to Sherpa altitude adaptation

James A. Horscroft, Aleksandra O. Kotwica, Verena Laner, James A. West, Philip J. Hennis, Denny Z. H. Levett, David J. Howard, Bernadette O. Fernandez, Sarah L. Burgess, Zsuzsanna Ament, Edward T. Gilbert-Kawai, André Vercueil, Blaine D. Landis, Kay Mitchell, Monty G. Mythen, Cristina Branco, Randall S. Johnson, Martin Feelisch, Hugh E. Montgomery, Julian L. GriffinMichael P. W. Grocott, Erich Gnaiger, Daniel S. Martin, Andrew J. Murray

Research output: Contribution to journalArticlepeer-review

97 Citations (Scopus)


The Himalayan Sherpas, a human population of Tibetan descent, are highly adapted to life in the hypobaric hypoxia of high altitude. Mechanisms involving enhanced tissue oxygen delivery in comparison to Lowlander populations have been postulated to play a role in such adaptation. Whether differences in tissue oxygen utilization (i.e., metabolic adaptation) underpin this adaptation is not known, however. We sought to address this issue, applying parallel molecular, biochemical, physiological, and genetic approaches to the study of Sherpas and native Lowlanders, studied before and during exposure to hypobaric hypoxia on a gradual ascent to Mount Everest Base Camp (5,300 m). Compared with Lowlanders, Sherpas demonstrated a lower capacity for fatty acid oxidation in skeletal muscle biopsies, along with enhanced efficiency of oxygen utilization, improved muscle energetics, and protection against oxidative stress. This adaptation appeared to be related, in part, to a putatively advantageous allele for the peroxisome proliferator-activated receptor A (PPARA) gene, which was enriched in the Sherpas compared with the Lowlanders. Our findings suggest that metabolic adaptations underpin human evolution to life at high altitude, and could have an impact upon our understanding of human diseases in which hypoxia is a feature.
Original languageEnglish
Pages (from-to)6382-6387
JournalProceedings of the National Academy of Sciences
Issue number24
Early online date22 May 2017
Publication statusPublished - 13 Jun 2017


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