Moderating role of gender in brain structural changes of long-term high-altitude hypoxia-exposed individuals

Gender differences play a significant role in human adaptation to both natural and social environments. In high-altitude regions, the reduced oxygen pressure leads to hypoxia, which is reflected in structural changes in the brain. However, the mechanisms by which gender regulates the effects of hypoxia on brain structure remain unclear. In this study, we measured brain morphology using magnetic resonance imaging (MRI) in 129 healthy adult subjects who had long-term migrated to the plateau. The difference test results showed that the volume of the right insula in the high-hypoxic exposure time group was significantly lower than that in the low-hypoxic exposure time group (t = −2.94, p < 0.01, 95% CI = [−1.08, −0.21]). Further moderating effect tests found that after controlling for age, gender moderated the effect of hypoxia exposure time on the relevant cortex. The reduction in the volume of the right insula showed the effect of long-term hypoxia, while Gender differences were associated with a reduction in the atrophy of the right insula volume (β = −0.16, t = −2.12, p < 0.05, 95 % CI = [−0.30, −0.01]), the thickness of the right pars opercularis (β = −0.19, t = −2.06, p < 0.05, 95 % CI = [−0.36, −0.01]), the thickness of the right posterior cingulate (β = −0.24, t = −2.60, p < 0.05, 95 % CI = [−0.42, −0.06]), and the thickness of the left caudal anterior cingulate (β = −0.21, t = −2.22, p < 0.05, 95 % CI = [−0.39, −0.02]). The findings of this study provide evidence for gender differences in moderating the adverse effects of long-term hypoxia exposure on the human brain in the high-altitude natural environment.