北京大学学报（医学版）2026，Vol.58Issue(1)：196-200,5.DOI:10.19723/j.issn.1671-167X.2026.01.026
血红蛋白影响血氧饱和度的性别特异性阈值:基于藏族住院患者的非线性回归分析
Sex-specific hemoglobin thresholds for oxygen saturation:A non-linear regression analysis based on Tibetan inpatients
摘要
Abstract
Objective:To investigate the complex association between hemoglobin levels and resting pulse oxygen saturation(SpO2)among surgical inpatients in a high-altitude environment,and to define precise,gender-specific physiological adaptation thresholds for hemoglobin,thereby providing evidence-based reference values for health management strategies in high-altitude populations.Methods:This cross-sectional study enrolled adult inpatients from People's Hospital of Xizang Autonomous Region(alti-tude:3 650 m)between January 2023 and October 2024.To rigorously evaluate the relationship between hemoglobin and resting SpO2,multivariate linear regression analysis was performed.Furthermore,re-stricted cubic spline models and likelihood ratio tests were utilized to explore potential non-linear thre-shold effects.Models were adjusted for potential confounding factors,including age,body mass index,hypertension,diabetes,smoking,alcoholism,and comorbid pulmonary diseases.Results:A total of 3 083 inpatients were enrolled in the final analysis,comprising 1 450 males and 1 633 females.The restricted cubic spline analysis revealed a significant non-linear relationship between hemoglobin levels and SpO2 for the total population(non-linear test,P=0.006),indicating a distinct turning point in the dose-response curve.Two-piecewise linear regression models subsequently identified distinct inflection points for each sex.For female inpatients,the hemoglobin threshold was determined to be 15.482 g/dL;Above this level,SpO2 significantly decreased as hemoglobin increased(β=-0.477,95％CI:-0.760 to-0.193,P=0.001).Similarly,for male inpatients,the threshold was identified at 17.288 g/dL;Exceeding this value resulted in a significant inverse correlation between hemoglobin and SpO2(β=-0.344,95％CI:-0.550 to-0.138,P=0.001).Conclusion:This study establishes specific hemoglobin thresholds for oxygenation status in hospitalized patients at high altitude:15.482 g/dL for females and 17.288 g/dL for males.Beyond these cut-off values,further increases in hemoglobin are associated with a deterioration in SpO2,suggesting a transition from physiological adaptation to maladaptive hemoconcentration.These findings highlight the necessity of sex-stratified hemoglobin monitoring and potential preoperative optimi-zation in high-altitude health management to prevent hypoxia-related complications.关键词
血氧饱和度/血红蛋白/高海拔/阈值效应/健康管理Key words
Oxygen saturation/Hemoglobin/Altitude/Threshold effect/Health management分类
医药卫生引用本文复制引用
贡觉卓玛,毛奕汀,达娃普珍,拉巴次仁,闫琦..血红蛋白影响血氧饱和度的性别特异性阈值:基于藏族住院患者的非线性回归分析[J].北京大学学报（医学版）,2026,58(1):196-200,5.基金项目
北京大学人民医院研究与发展基金(RDJP2022-68、RDE2022-21)、北京市住院医师规范化培训质量提高项目(2023011)、西藏自治区自然科学基金组团式医疗援藏项目[XZ2024ZR-ZY013(Z)]Supported by Peking University People's Hospital Research and Development Funds(RDJP2022-68,RDE2022-21),Beijing Resident Standardized Training Quality Improvement Project(2023011),Xizang Autonomous Region Natural Science Foundation Group Medical Aid Project[XZ2024ZR-ZY013(Z)] （RDJP2022-68、RDE2022-21）
