Hematological Parameters in Native Highlanders of Ladakh Aged 4–19 Years

  • Uday YanamandraEmail author
  • Srinivas A. Bhattachar
  • Subrat K. Das
  • Sushma Yanamandra
  • V. K. Lalitha Kumari
  • Angella Ayekappam
  • Suman Kumar
  • Pankaj Malhotra
  • Subhash Varma
  • Neelam Varma
  • Velu Nair
Original Article


Hematological adaptations to high altitude (HA) are long studied but are focused either on lowlanders visiting HA or native highlanders from Andes and Tibet. The literature on native highlanders from the Indian subcontinent or paediatric highlanders is scarce. We aimed at assessing hematological parameters in native highlanders of Ladakh, India, aged 4–19 years and derive nomograms in an age stratified manner specific to these native highlanders. A total of 335 self-reported healthy native highlanders of Ladakh, without any known comorbidities and not on hematinic nor any drugs in the age group of 4–19 years were included in the study. Complete hemogram including red cell indices was measured. R ver 3.4.0 was used to compare the hematological parameters based on gender/age stratification, pubertal and nutritional status. The hematological reference ranges were created for various parameters in the paediatric population. The mean (SD) haemoglobin (Hb) concentration was 14.74 (2.07) gm/dL. The mean hematocrit (Hct) was 40.43 (5.57%) %, mean corpuscular volume (MCV) was 81.87 (7.22) fL, white blood cell (WBC) count was 7596 (2172) cells/μL and platelets was 378.4 (152.8) × 103/μL. Hct and MCV increased with age. Hb concentration, Hct, and MCV in girls was significantly lower than boys. Severely underweight subjects (body mass index < 16) showed significantly higher platelet counts compared to their nourished counterparts. The hematological nomograms for the native paediatric highlanders from Ladakh, India have been reported in this study.


Hemogram Paediatric Highlanders Ladakh India 


Authors’ Contributions

UY: Study design, data collection and analysis, manuscript preparation. SK: Data analysis, manuscript preparation. SAB: Study design. SKD: Data analysis, manuscript preparation. SY: Data collection and analysis. VKLK: Data collection. AA: Data collection. PM: Study design. SV: Study design, manuscript preparation. NV: Study design. VN: Study design, manuscript preparation.


This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the 14 Corps Institutional Ethics Clearance Committee. Written informed consent was obtained from parents/guardians of all subjects.

Supplementary material

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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Uday Yanamandra
    • 1
    Email author
  • Srinivas A. Bhattachar
    • 2
  • Subrat K. Das
    • 3
  • Sushma Yanamandra
    • 4
  • V. K. Lalitha Kumari
    • 5
  • Angella Ayekappam
    • 5
  • Suman Kumar
    • 6
  • Pankaj Malhotra
    • 7
  • Subhash Varma
    • 7
  • Neelam Varma
    • 8
  • Velu Nair
    • 9
  1. 1.Department of HematologyArmy Hospital (Research & Referral)Delhi CanttIndia
  2. 2.Department of PhysiologyArmed Forces Medical CollegePuneIndia
  3. 3.EME SchoolVadodaraIndia
  4. 4.Max HospitalMohaliIndia
  5. 5.Military Nursing ServicesIntegrated HQ, Ministry of DefenceNew DelhiIndia
  6. 6.Army Hospital (Research & Referral)DelhiIndia
  7. 7.Department of Internal MedicinePGIMERChandigarhIndia
  8. 8.Department of HematologyPGIMERChandigarhIndia
  9. 9.Director General Medical Services (Army)Integrated Headquarters Ministry of DefenceDelhiIndia

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