Cao, Xue-Feng, Zhen-Zhong Bai, Lan Ma, Shuang Ma, and Ri-Li Ge. Metabolic alterations of Qinghai-Tibet plateau pikas in adaptation to high altitude. High Alt Med Biol. 18:219-225, 2017.-To determine specific metabolic alterations in the myocardium of plateau pikas (Ochotona curzoniae) and potential metabolic biomarkers involved in their adaptation to the high-altitude environment of the Qinghai-Tibet Plateau. Ten pikas were captured by traps in the Kekexili Reserve (4630 m a.s.l; n = 5) and at the foot of the Laji Mountain (2600 m a.s.l; n = 5) on the Qinghai-Tibet Plateau, Qinghai Province, China. Metabolite levels were determined by gas chromatography time-of-flight mass spectrometry (GC-TOF-MS) metabolomics, and multivariate statistical analysis was performed. Several metabolites involved in carbohydrate, fat, energy, and redox homeostasis pathways were significantly altered in pikas living at 4630 m. In addition, those pikas showed increased levels of lactic acid, sarcosine, 4-hydroxybutyrate, methionine, tartaric acid, ribose, tyrosine, pentadecanoic acid, 2-monoolein, 3,5-dihydroxyphenylglycine, trehalose-6-phosphate, succinic acid, myoinositol, fumaric acid, taurine, 2-hydroxybutanoic acid, gluconic acid, citrulline, and glutathione, but decreased levels of oleic acid and 2'-deoxyadenosine 5'-monophosphate. Metabolic activity is significantly altered in the myocardium of pikas in the high-altitude areas of the Qinghai-Tibet Plateau. This study provides important insights into metabolic biomarkers related to the adaptation of pikas to high-altitude hypoxia.