Human skeletal muscle wasting in hypoxia: a matter of hypoxic dose?

Skeletal muscle wasting has been shown to be a mechanism by which humans are able to adapt to extreme altitude. Nonetheless, the literature is conflicting regarding the altitude or time point at which this phenomenon starts to occur. Using the metric recently suggested by Garvivan-Lewis et al. (8), we propose an hypoxic dose of 5000 km·h as the cut-off point above which hypoxia-induced muscle atrophy starts to develop. As such, we suggest that both elevation and hours of altitude exposure should be incorporated in future studies unraveling hypoxic regulation of muscle mass.