Prediction of acute mountain sickness risk by pre-plateau uric acid and albumin levels in Chinese young males: a prospective cohort study

Objective To screen and identify pre-plateau hematological parameters that can predict the risk of acute mountain sickness (AMS) in individuals rapidly ascending to high altitudes. Methods A total of 297 healthy adult males with an average age of 20.88 ± 1.76 years were included in the study. Baseline data were collected at an altitude of 300 m using questionnaire surveys, on-site testing, and hematological parameter tests (including routine blood and serum biochemical parameters with validated clinical detection systems). After ascending to an altitude of 4,200 m, the Lake Louise Score (LLS) 2018 and physiological indicator measurements were obtained on the second day. AMS was defined as an LLS 2018 ≥3 points accompanied by headache. A univariate logistic regression model was used to screen for the hematological parameters associated with AMS. Multivariate logistic regression was then used to adjust for covariates and determine the relationship between pre-plateau albumin (ALB) levels, uric acid (UA) levels, UA-to-ALB ratio (UAR), and AMS risk. Additionally, the predictive value was assessed using the receiver operating characteristic (ROC) curve, and the optimal cutoff value was determined using the Youden index. Finally, a subgroup analysis was conducted to determine the consistency of associations. Results The incidence of AMS after arriving at the 4,200 m plateau was 29.97%. Univariate logistic regression analysis revealed associations between factors at 300 m, including heart rate, alcohol consumption, ALB, UA, and AMS. In the fully adjusted multivariate Model 3, pre-plateau ALB, UA, and UAR showed moderate predictive performance for AMS, with area under the ROC curve values of 0.710, 0.701, and 0.711, respectively (all P < 0.001). The optimal cutoff values were 47.25 g/L for ALB, 420.10 μmol/L for UA, and 7.45 for UAR. The UAR exhibited favorable predictive performance in populations with a body mass index <25 kg/m 2 , a history of low-altitude residence, or alcohol consumption. Conclusion Pre-plateau UA levels, ALB levels, and UAR are independent predictors of AMS risk in young healthy Chinese males. All three biomarkers exhibited moderate predictive performance, with the UAR showed particular utility in specific subgroups.