脐带血维生素 D 水平与学龄前儿童夜间睡眠时间：EDEN 母婴队列研究。

Cord-blood vitamin D level and night sleep duration in preschoolers in the EDEN mother-child birth cohort.

机构信息

INSERM, UMR1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center (CRESS), Early ORigins of Child Health and Development Team (ORCHAD), Villejuif, F-94807, France; Univ Paris-Descartes, UMRS 1153, Paris, France.

出版信息

Sleep Med. 2019 Jan;53:70-74. doi: 10.1016/j.sleep.2018.09.017. Epub 2018 Oct 11.

DOI:10.1016/j.sleep.2018.09.017

PMID:30447402

Abstract

OBJECTIVE

Deficiency in 25-hydroxyvitamin D (25OHD) has been associated with sleep disorders in adults. Only three cross-sectional studies were performed in children; which showed an association between 25OHD deficiency and both obstructive sleep apnea syndrome and primary snoring. No longitudinal study has been performed in children from the general population. We analyzed the association between cord-blood vitamin D levels at birth and night-sleep duration trajectories for children between 2 and 5-6 years old in a non-clinical cohort.

METHOD

We included 264 children from the French EDEN mother-child birth-cohort with cord-blood 25OHD level determined by radio-immunoassay at birth, and night-sleep trajectories for children between 2 and 5-6 years old obtained by the group-based trajectory modeling method. Associations between 25OHD and sleep trajectories were assessed by multinomial logistic regression adjusted for maternal and child characteristics.

RESULTS

The trajectories short sleep (<10h30/night), medium-low sleep (10h30-11h00/night), medium-high sleep (≈11h30/night), long sleep (≥11h30/night) and changing sleep (decreased from ≥11h30 to 10h30-11h00/night) represented 5%, 46%, 37%, 4% and 8% of the children, respectively. The mean 25OHD level was 19 ng/ml (SD = 11, range 3-63). It was 12 (SD = 7), 20 (SD = 11), 19 (SD = 10), 14 (SD = 7) and 16 (SD = 8) ng/ml for children with short, medium-low, medium-high, long and changing sleep trajectories, respectively. On adjusted analysis, for each 1-ng/ml decrease in 25OHD level, the odds of belonging to the short sleep versus medium-high sleep trajectory was increased (odds ratio = 1.12, 95% confidence interval [1.01-1.25]). We found no other significant association between 25OHD level and other trajectories.

CONCLUSION

A low 25OHD level at birth may be associated with an increased probability of being a persistent short sleeper in preschool years. These results need confirmation.

摘要

目的

维生素 D 缺乏症（25OHD）与成年人的睡眠障碍有关。仅在儿童中进行了三项横断面研究；这些研究表明 25OHD 缺乏症与阻塞性睡眠呼吸暂停综合征和原发性打鼾均有关。在普通人群中，尚未对儿童进行过纵向研究。我们在一个非临床队列中分析了脐带血维生素 D 水平与 2 至 5-6 岁儿童夜间睡眠持续时间轨迹之间的关系。

方法

我们纳入了来自法国 EDEN 母婴出生队列的 264 名儿童，出生时通过放射免疫法测定脐带血 25OHD 水平，并通过基于群组的轨迹建模方法获得儿童 2 至 5-6 岁的夜间睡眠轨迹。通过多变量逻辑回归，在调整了母亲和儿童特征后，评估了 25OHD 与睡眠轨迹之间的关联。

结果

短睡眠（<10 小时 30 分钟/夜）、中低睡眠（10 小时 30 分钟-11 小时 00 分/夜）、中高睡眠（≈11 小时 30 分/夜）、长睡眠（≥11 小时 30 分/夜）和睡眠变化（从≥11 小时 30 分减少到 10 小时 30 分-11 小时 00 分/夜）分别代表了 5%、46%、37%、4%和 8%的儿童。平均 25OHD 水平为 19ng/ml（标准差[SD]=11，范围 3-63）。短、中低、中高、长和睡眠变化轨迹的儿童分别为 12ng/ml（SD=7）、20ng/ml（SD=11）、19ng/ml（SD=10）、14ng/ml（SD=7）和 16ng/ml（SD=8）。在调整分析中，25OHD 水平每降低 1ng/ml，属于短睡眠轨迹的可能性就会增加（比值比[OR]=1.12，95%置信区间[1.01-1.25]）。我们没有发现 25OHD 水平与其他轨迹之间的其他显著关联。