{
  "abstract": "IntroductionOxygen saturation (SpO2) is used to detect hypoxemia and guide oxygen therapy, but its interpretation varies with altitude, age, and lung disease. Although >500 million people live at ≥1,500 m, population-based data comparing SpO2 across altitudes in adults with and without chronic respiratory disease are scarce. We aimed to compare SpO2 between these groups from sea level to 3,030 m, identify factors associated with SpO2, and describe SpO2 by altitude and age in adults without respiratory disease. We hypothesized that SpO2 would be lower in participants with respiratory disease, with differences increasing with altitude.MethodsPREPOCOL II is a population-based, cross-sectional study with a probabilistic, two-stage, clustered sampling design to estimate the prevalence and risk factors for respiratory disease among adults ≥40 years in Colombian cities at different altitudes (18-3030 m). All participants completed a standardized questionnaire, spirometry, and SpO2 measurement. Participants with respiratory disease (RDP), including chronic obstructive pulmonary disease, asthma, chronic bronchitis, obstructive sleep apnea, and interstitial lung disease, were compared with controls using Mann-Whitney and Kruskal-Wallis tests, multivariable linear regression, and comparisons of altitude coefficients between groups.ResultsA total of 1146 RDP and 4613 controls were included. RDP were older, and had lower BMI and lung function. SpO2 was lower in RDP than in controls at all altitudes and decreased in both groups as altitude and age increased (p<0.001). In multivariable models, altitude showed the strongest association with SpO2 (standardized β −0.69 in controls and −0.71 in RDP), followed by age and BMI (and FEV1 in RDP). The decrease in SpO2 per unit of altitude was larger in RDP (B −1.15 vs. −0.80; difference p<0.001), and the between-group difference became evident at ~1,500 m (median 97.0% vs. 95.5%).ConclusionAmong lifelong residents living at altitudes from sea level to 3,030 m, SpO2 was lower in RDP than in controls. SpO2 decreased with altitude and age in both groups, with altitude being the variable most strongly associated with SpO2. SpO2 values should be interpreted in relation to specific altitude and age. In RDP, the lower SpO2 was most evident at altitudes of ~1,500 m and above.",
  "abstract_shown": true,
  "affiliations": [
    "Fundación Neumológica Colombiana, Bogotá, Colombia",
    "Universidad de La Sabana, Chia, Colombia",
    "Department of Radiology. Fundación Cardioinfantil, Bogotá, Colombia"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mauricio Gonzalez-Garcia"
    },
    {
      "affs": [
        1
      ],
      "name": "Mauricio Gonzalez-Garcia"
    },
    {
      "affs": [
        0
      ],
      "name": "Carlos A. Torres-Duque"
    },
    {
      "affs": [
        1
      ],
      "name": "Carlos A. Torres-Duque"
    },
    {
      "affs": [
        0
      ],
      "name": "Carlos Aguirre-Franco"
    },
    {
      "affs": [
        1
      ],
      "name": "Carlos Aguirre-Franco"
    },
    {
      "affs": [
        0
      ],
      "name": "Abraham Alí-Munive"
    },
    {
      "affs": [
        1
      ],
      "name": "Abraham Alí-Munive"
    },
    {
      "affs": [
        0
      ],
      "name": "Nadia Juliana Proaños"
    },
    {
      "affs": [
        1
      ],
      "name": "Nadia Juliana Proaños"
    },
    {
      "affs": [
        2
      ],
      "name": "Carolina Perez"
    },
    {
      "affs": [
        0
      ],
      "name": "Alejandro Casas-Herrera"
    },
    {
      "affs": [
        1
      ],
      "name": "Alejandro Casas-Herrera"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/enx6fszfq9ph0.bib",
  "cited_by": 0,
  "doi": "10.3389/fphys.2026.1956566",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fphys.2026.1956566/full",
  "id": "enx6fszfq9ph0",
  "issns": [
    "1664-042X"
  ],
  "landing_url": "https://doi.org/10.3389/fphys.2026.1956566",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "QP1-981"
    ],
    [
      "openalex",
      "1311|High Altitude and Hypoxia"
    ]
  ],
  "openalex": "W7223707489",
  "pdf_url": "https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2026.1956566/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-26",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/enx6fszfq9ph0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:47:18Z",
      "native_id": "21ebcfe8e75847bd985c08f5afe5fdc5",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fphys.2026.1956566"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|High Altitude and Hypoxia",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Differences in pulse oximetry saturation from sea level to high altitude among subjects with and without respiratory disease. A population-based, cross-sectional study",
  "title_text": "Differences in pulse oximetry saturation from sea level to high altitude among subjects with and without respiratory disease. A population-based, cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:47:18Z",
  "url": "https://research.draconitic.com/paper/enx6fszfq9ph0",
  "venue": "Frontiers in Physiology",
  "versions": []
}