CC BY-NC-ND 4.0 · Sports Med Int Open 2018; 02(04): E98-E104
DOI: 10.1055/a-0655-7207
Physiology & Biochemistry
Eigentümer und Copyright ©Georg Thieme Verlag KG 2018

The Influence of Oxygen Saturation on the Relationship Between Hemoglobin Mass and VO2max

Jesse A. Goodrich
1   Department of Integrative Physiology, University of Colorado Boulder, Boulder, United States
Benjamin J. Ryan
1   Department of Integrative Physiology, University of Colorado Boulder, Boulder, United States
William C. Byrnes
1   Department of Integrative Physiology, University of Colorado Boulder, Boulder, United States
› Author Affiliations
Further Information

Publication History

received 12 February 2018
revised   11 May 2018

accepted 05 June 2018

Publication Date:
06 September 2018 (online)


Hemoglobin mass (tHb) is a key determinant of maximal oxygen uptake (VO2max). We examined whether oxyhemoglobin desaturation (ΔSaO2) at VO2max modifies the relationship between tHb and VO2max at moderate altitude (1,625 m). Seventeen female and 16 male competitive, endurance-trained moderate-altitude residents performed two tHb assessments and two graded exercise tests on a cycle ergometer to determine VO2max and ΔSaO2. In males and females respectively, VO2max (ml·kg−1·min−1) ranged from 62.5–83.0 and 44.5–67.3; tHb (g·kg−1) ranged from 12.1–17.5 and 9.1–13.0; and SaO2 at VO2max (%) ranged from 81.7–94.0 and 85.7–95.0. tHb was related to VO2max when expressed in absolute terms and after correcting for body mass (r=0.94 and 0.86, respectively); correcting by ΔSaO2 did not improve these relationships (r=0.93 and 0.83). Additionally, there was a negative relationship between tHb and SaO2 at VO2max (r=–0.57). In conclusion, across a range of endurance athletes at moderate altitude, the relationship between tHb and VO2max was found to be similar to that observed at sea level. However, correcting tHb by ΔSaO2 did not explain additional variability in VO2max despite significant variability in ΔSaO2; this raises the possibility that tHb and exercise-induced ΔSaO2 are not independent in endurance athletes.

  • References

  • 1 Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc 2000; 32: 70-84
  • 2 Brocherie F, Millet GP, Hauser A, Steiner T, Rysman J, Wehrlin JP, Girard O. “Live high–train low and high” hypoxic training improves team-sport performance. Med Sci Sports Exerc 2015; 47 (10) 2140-2149
  • 3 Brothers MD, Hilger K, Carson JM, Sullivan L, Byrnes WC. GXT responses in altitude-acclimatized cyclists during sea-level simulation. Med Sci Sports Exerc 2007; 39: 1727-1735
  • 4 Buchfuhrer MJ, Hansen JE, Robinson TE, Sue DY, Wasserman K, Whipp BJ. Optimizing the exercise protocol for cardiopulmonary assessment. J Appl Physiol 1983; 55: 1558-1564
  • 5 Dempsey J, Amann M, Harms C, Wetter T. Respiratory system limitations to performance in the healthy athlete: Some answers, more questions!. Dtsch Z Für Sportmed 2012; 157-162
  • 6 Dempsey JA, Hanson PG, Henderson KS. Exercise-induced arterial hypoxaemia in healthy human subjects at sea level. J Physiol 1984; 355: 161-175
  • 7 Dempsey JA, Wagner PD. Exercise-induced arterial hypoxemia. J Appl Physiol 1999; 87: 1997-2006
  • 8 Dominelli PB, Foster GE, Dominelli GS, Henderson WR, Koehle MS, McKenzie DC, Sheel AW. Exercise-induced arterial hypoxaemia and the mechanics of breathing in healthy young women: Hypoxaemia and ventilatory mechanics in exercising women. J Physiol 2013; 591: 3017-3034
  • 9 Dominelli PB, Render JN, Molgat-Seon Y, Foster GE, Romer LM, Sheel AW. Oxygen cost of exercise hyperpnoea is greater in women compared with men. J Physiol 2015; 593: 1965-1979
  • 10 Dunn A, Lo V, Donnelly S. The role of the kidney in blood volume regulation: The kidney as a regulator of the hematocrit. Am J Med Sci 2007; 334: 65-71
  • 11 Edgett BA, Bonafiglia JT, Raleigh JP, Rotundo MP, Giles MD, Whittall JP, Gurd BJ. Reproducibility of peak oxygen consumption and the impact of test variability on classification of individual training responses in young recreationally active adults. Clin Physiol Funct Imaging 2017; 38: 630-638
  • 12 Gaston A-F, Durand F, Roca E, Doucende G, Hapkova I, Subirats E. Exercise-induced hypoxaemia developed at sea level influences responses to exercise at moderate altitude. PLoS One 2016; 11: e0161819
  • 13 Gore CJ, Sharpe K, Garvican-Lewis LA, Saunders PU, Humberstone CE, Robertson EY, Wachsmuth NB, Clark SA, McLean BD, Friedmann-Bette B, Neya M, Pottgiesser T, Schumacher YO, Schmidt WF. Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method determined by a meta-analysis. Br J Sports Med 2013; 47: i31-i39
  • 14 Guenette JA, Witt JD, McKenzie DC, Road JD, Sheel AW. Respiratory mechanics during exercise in endurance-trained men and women. J Physiol 2007; 581: 1309-1322
  • 15 Harms CA, McClaran SR, Nickele GA, Pegelow DF, Nelson WB, Dempsey JA. Effect of exercise-induced arterial O2 desaturation on VO2max in women. Med Sci Sports Exerc 2000; 32: 1101-1108
  • 16 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
  • 17 Hopkins WG. Measures of reliability in sports medicine and science. Sports Med 2000; 30: 1-15
  • 18 Horwitz LD, Lindenfeld J. Effects of enhanced ventricular filling on cardiac pump performance in exercising dogs. J Appl Physiol 1985; 59: 1886-1890
  • 19 Joyner MJ. Physiological limits to endurance exercise performance: influence of sex. J Physiol 2017; 595: 2949-2954
  • 20 Joyner MJ, Coyle EF. Endurance exercise performance: The physiology of champions. J Physiol 2008; 586: 35-44
  • 21 Krip B, Gledhill N, Jamnik V, Warburton D. Effect of alterations in blood volume on cardiac function during maximal exercise. Med Sci Sports Exerc 1997; 29: 1469-1476
  • 22 Lawler J, Powers SK, Thompson D. Linear relationship between VO2max and VO2max decrement during exposure to acute hypoxia. J Appl Physiol 1988; 64: 1486-1492
  • 23 Lundby C, Montero D, Joyner M. Biology of VO2 max: looking under the physiology lamp. Acta Physiol 2016 Available from:
  • 24 Lundby C, Robach P. Performance enhancement: What are the physiological limits?. Physiology 2015; 30: 282-292
  • 25 Powers SK, Martin D, Cicale M, Collop N, Huang D, Criswell D. Eur J Appl Physiol 1988; 58: 298-302
  • 26 Powers SK, Dodd S, Lawler J, Landry G, Kirtley M, McKnight T, Grinton S. Incidence of exercise-induced hypoxemia in elite endurance athletes at sea level. Eur J Appl Physiol 1992; 65: 37-42
  • 27 Prommer N, Schmidt W. Loss of CO from the intravascular bed and its impact on the optimised CO-rebreathing method. Eur J Appl Physiol 2007; 100: 383-391
  • 28 Prommer N, Thoma S, Quecke L, Gutekunst T, VöLzke C, Wachsmuth N, Niess AM, Schmidt W. Total hemoglobin mass and blood volume of elite Kenyan runners. Med Sci Sports Exerc 2010; 42: 791-797
  • 29 Roberts D, Smith DJ. Erythropoietin concentration and arterial haemoglobin saturation with supramaximal exercise. J Sports Sci 1999; 17: 485-493
  • 30 Roberts D, Smith DJ, Donnelly S, Simard S. Plasma-volume contraction and exercise-induced hypoxaemia modulate erythropoietin production in healthy humans. Clin Sci 2000; 98: 39-45
  • 31 Rowell LB, Taylor HL, Wang Y, Carlson WS. Saturation of arterial blood with oxygen during maximal exercise. J Appl Physiol 1964; 19: 284-286
  • 32 Ryan BJ, Goodrich JA, Schmidt W, Kane LA, Byrnes WC. Ten days of intermittent, low-dose carbon monoxide inhalation does not significantly alter hemoglobin mass, aerobic performance predictors, or peak-power exercise tolerance. Int J Sports Med 2016; 37: 884-889
  • 33 Ryan BJ, Goodrich JA, Schmidt WF, Stothard ER, Wright KP, Byrnes WC. Haemoglobin mass alterations in healthy humans following four-day head-down tilt bed rest. Exp Physiol 2016; 101: 628-40
  • 34 Schmidt W, Prommer N. The optimised CO-rebreathing method: A new tool to determine total haemoglobin mass routinely. Eur J Appl Physiol 2005; 95: 486-495
  • 35 Schmidt W, Prommer N. Impact of alterations in total hemoglobin mass on VO2max. Exerc Sport Sci Rev 2010; 38: 68-75
  • 36 Scroop GC, Shipp NJ. Exercise-induced hypoxemia: Fact or fallacy?. Med Sci Sports Exerc 2010; 42: 120-126
  • 37 Yamaya Y, Bogaard HJ, Wagner PD, Niizeki K, Hopkins SR. Validity of pulse oximetry during maximal exercise in normoxia, hypoxia, and hyperoxia. J Appl Physiol 2002; 92: 162-168