Obesity is associated with a lower resting oxygen saturation in the ambulatory elderly: Results from the cardiovascular health study
Open accessAbstract
BACKGROUND: The contribution of obesity to hypoxemia has not been reported in a community-based study. Our hypothesis was that increasing obesity would be independently associated with lower SpO2 in an ambulatory elderly population. METHODS: The Cardiovascular Health Study ascertained resting SpO2 in 2,252 subjects over age 64. We used multiple linear regression to estimate the association of body mass index (BMI) with SpO2 and to adjust for potentially confounding factors. Covariates including age, sex, race, smoking, airway obstruction (based on spirometry), self reported diagnosis of emphysema, asthma, heart failure, and left ventricular function (by echocardiography) were evaluated. RESULTS: Among 2,252 subjects the mean and median SpO2 were 97.6% and 98.0% respectively; 5% of subjects had SpO2 values below 95%. BMI was negatively correlated with SpO2 (Spearman R = -0.27, P < .001). The mean difference in SpO2 between the lowest and highest BMI categories (< 25 kg/m(2) and ≥ 35 kg/m(2)) was 1.33% (95% CI 0.89-1.78%). In multivariable linear regression analysis, SpO2 was significantly inversely associated with BMI (1.4% per 10 units of BMI, 95% CI 1.2-1.6, for whites/others, and 0.87% per 10 units of BMI, 95% CI 0.47-1.27, for African Americans). CONCLUSIONS: We found a narrow distribution of SpO2 values in a community-based sample of ambulatory elderly. Obesity was a strong independent contributor to a low SpO2, with effects comparable to or greater than other factors clinically associated with lower SpO2.
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Publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited.
“While, to the authors’ knowledge, publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited, we will explore works which suggest that there would be a substantial effect [56,59,60,61,62,63,64,65,66,67,68,69,70].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [66]
Oxygen saturation of hemoglobin has consistently been shown to be inversely associated with BMI across various populations.
“Lastly, oxygen saturation of hemoglobin has consistently been shown to be inversely associated with BMI across various populations [66,67,73].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [66]
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Cites
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Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring
Fine, J., Branan, K. L., Rodriguez, A. J., Boonya-ananta, T., Ajmal, Ramella-Roman, J. C., McShane, M. J., & Coté, G. L. (2021) · Biosensors · doi:10.3390/bios11040126 · Cited by 348 · see citing works
- Authors
- Kapur, V. K., Wilsdon, A. G., Au, D., Avdalovic, M., Enright, P., Fan, V. S., Hansel, N. N., Heckbert, S. R., Jiang, R., Krishnan, J. A., Mukamal, K., Yende, S., & Barr, R. G.
- Affiliations
- University of Washington (US)
- University of California, Davis (US)
- University of Arizona (US)
- Johns Hopkins University (US)
- Columbia University Irving Medical Center (US)
- University of Illinois Chicago (US)
- Beth Israel Deaconess Medical Center (US)
- University of Pittsburgh (US)
- ORCID
- Venue
- Respiratory Care
- Publisher
- SAGE Publications
- Published
- 2013-05-01
- Volume
- 58
- Issue
- 5
- Pages
- 831-837
- ISSN
- 0020-1324 (ISSN-L)
- PMC
- PMC3885157
- OpenAlex
- W2120974255
- Cited by
- 33
- References
- 14
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 10 · 2021: 2 · 2019: 1 · 2017: 2 · 2016: 2 · 2014: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Respiratory Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Washington
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc045133-001, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc55222-0-0-0, n01hc075150-004, n01hc035129-010)
- National Institute on Aging (AG 20098, R56AG023629, R01AG020098, AG023629, AG027058, R56AG020098, R01AG023629, R01AG015928, R01AG027058)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01 HC085086, N01HC-85083, N0-1-HC-85239, N01 HC085079, N01 HC085083, N01HC85082, N01HC‐75150, N01 HC85086, N01 HC085080, HHSN 268200800007C, N01 HC035129, N01HC85080, N01 HC015103, N01 HC55222, HHSN268201200036C, N01HC085082, U01HL080295, N01 HC055222, N01 HC085081, HL080295, R01HL080295, N01 HC075150, N01 HC085084, N01 HC045133, N01-HC85079)
- National Institute of Neurological Disorders and Stroke
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- obesity, hypoxemia, body mass index, older adults, community-dwelling older adults, Cardiovascular Health Study, racial differences, airway obstruction, emphysema, asthma, heart failure, left ventricular function
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Black or African American, Female, Humans, Male, Obesity, Oximetry, Oxygen, Smoking, Body Mass Index, White People, Waist Circumference
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