{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:38:03Z","timestamp":1792690683736,"version":"4.5.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute mountain sickness (AMS) is a common disorder affecting individuals who are exposed to high-altitude environments, generally defined as an elevation of above 2,500 meters. Identifying risk factors for AMS susceptibility before exposure is essential for prevention. According to current research, different constitution types exhibit varying tolerance to acute hypoxia. Exploring the relationship between Traditional Chinese Medicine (TCM) constitution and AMS may therefore provide novel perspectives for prevention and treatment from a TCM standpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 183 healthy young male participants were enrolled and assessed for TCM constitution, demographic characteristics, clinical indices, and 3,000-meter run performance at low altitude (200\u202fm). After rapid ascent from low altitude to 3,600\u202fm by airplane within 3\u202fh, participants were evaluated for AMS using the Lake Louise Score (LLS). Logistic regression was applied to assess the association between TCM constitution types and AMS, and then linear regression was applied to explore factors associated with Qi deficiency constitution. Structural equation modeling (SEM) was employed to investigate whether aerobic fitness, as reflected by 3,000-meter run performance, mediated the relationship between Qi deficiency constitution and AMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of AMS was 40.4%. Among the nine TCM constitution types, only Qi deficiency was independently associated with an increased risk of AMS (adjusted OR\u202f=\u202f1.09, 95% CI: 1.01\u20131.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.03). Qi deficiency was significantly associated with 3,000-meter run time, red blood cell count, hemoglobin level, and alcohol intake status. SEM revealed that 3,000-meter run time significantly mediated the association between Qi deficiency and AMS (indirect effect\u202f=\u202f0.071, 95% CI: \u22120.003 to 0.090,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004), while the direct effect was not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Qi deficiency constitution is an independent risk factor for AMS, and this association is mediated through reduced aerobic fitness, reflected by 3,000-meter run performance. Assessing TCM constitution could be a new way to identify individuals at higher risk for AMS before high-altitude exposure. Pre-acclimatization strategies aimed at improving Qi deficiency or enhancing aerobic capacity could help prevent AMS in susceptible populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1738945","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:37:07Z","timestamp":1771223827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Qi deficiency constitution increases risk of acute mountain sickness via reduced aerobic fitness"],"prefix":"10.3389","volume":"14","author":[{"given":"Shiwei","family":"Shen","sequence":"first","affiliation":[{"name":"State Key Laboratory of Genetics and Development of Complex Phenotypes, School of Life Sciences, Fudan University","place":["Shanghai, China"]},{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidan","family":"Gao","sequence":"additional","affiliation":[{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingxian","family":"Zhu","sequence":"additional","affiliation":[{"name":"Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shixuan","family":"Dai","sequence":"additional","affiliation":[{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]},{"name":"Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Sciences, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Tian","sequence":"additional","affiliation":[{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Jin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Genetics and Development of Complex Phenotypes, School of Life Sciences, Fudan University","place":["Shanghai, China"]},{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiucun","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Genetics and Development of Complex Phenotypes, School of Life Sciences, Fudan University","place":["Shanghai, China"]},{"name":"Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1472935","DOI":"10.3389\/fpubh.2024.1472935","article-title":"Dynamics in the prevalence and clinical manifestations of acute mountain sickness of different ascent protocols during high altitudes exposure","volume":"12","author":"Zhao","year":"2024","journal-title":"Front Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/j.rceng.2019.12.009","article-title":"Acute, subacute and chronic mountain sickness","volume":"221","author":"Garrido","year":"2021","journal-title":"Revista Cl\u00ednica Espa\u00f1ola (English Edition)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1089\/ham.2019.0123","article-title":"Altitude, 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