Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD.
Department of Epidemiology & Biostatistics, University of Maryland, College Park.
J Affect Disord. 2021 Mar 1;282:858-868. doi: 10.1016/j.jad.2020.12.145. Epub 2020 Dec 29.
We examined relationships of vitamin D status with over time changes in patterns of sleep in a longitudinal study of Whites and African-American urban middle-aged adults, while further testing effect modification by age group, sex and race and the potential roles of dietary and supplemental vitamin D.
Data on 1,760 middle-aged participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS study: Age range at v: 33-71y, mean±SD:53.0±8.8, % women: 58.4%, % African-American:60.3%) were used, with complete baseline 25-hydroxyvitamin D [25(OH)D] serum concentration data, initial selected covariates and mediators, and initial and/or follow-up data on five sub-scales (sleep duration, daytime dysfunction, sleep disturbance, sleep latency and sleep quality) of the Pittsburgh Sleep Quality Index. Mean±SD time between initial and follow-up visits: 4.1±1.5 years. Time-interval multiple mixed-effects linear regression models were used.
Upon multiple testing adjustment, among Whites, initial 25(OH)D was associated with better sleep duration [25(OH)D × TIME γ±SE: -0.027±0.011, P=0.017] and sleep quality [25(OH)D × TIME γ±SE: -0.026±0.010, P=0.008] over time, with heterogeneity by race found for both relationships (P<0.05 for 25(OH)D × TIME × Race in the un-stratified model). These relationships remained unaltered after further adjustment for dietary and supplemental vitamin D, indicating that this association may be largely explained by sunlight exposure.
Limitations included small sample size, selection bias, residual confounding and lack of objective sleep measures. Conclusions Vitamin D status, possibly through mechanisms involving sunlight exposure, was linked to a potential improvement in sleep duration and quality among White urban adults.
我们在一项针对白人和非裔美国城市中年成年人的纵向研究中，研究了维生素 D 状况与随时间变化的睡眠模式之间的关系，同时进一步测试了年龄组、性别和种族的效应修饰作用，以及饮食和补充维生素 D 的潜在作用。
本研究使用了来自多样性邻里健康老龄化研究（HANDLS 研究：基线时年龄范围为 33-71 岁，平均±标准差为 53.0±8.8，女性百分比为 58.4%，非裔美国人百分比为 60.3%）的 1760 名中年参与者的数据，这些参与者具有完整的基线 25-羟维生素 D [25(OH)D]血清浓度数据、初始选择的协变量和介质，以及匹兹堡睡眠质量指数五个子量表（睡眠时间、日间功能障碍、睡眠障碍、睡眠潜伏期和睡眠质量）的初始和/或随访数据。初始和随访访问之间的平均时间间隔为 4.1±1.5 年。采用时间间隔多混合效应线性回归模型。
经过多次测试调整，在白人中，初始 25(OH)D 与更好的睡眠时间[25(OH)D×TIME γ±SE：-0.027±0.011，P=0.017]和睡眠质量[25(OH)D×TIME γ±SE：-0.026±0.010，P=0.008]随时间的变化有关，同时发现种族之间存在异质性（在未分层模型中，25(OH)D×TIME×Race 的 P<0.05）。这些关系在进一步调整饮食和补充维生素 D 后仍然没有改变，表明这种关联可能主要归因于阳光暴露。
研究存在样本量小、选择偏倚、残余混杂和缺乏客观睡眠测量等局限性。结论：维生素 D 状况可能通过涉及阳光暴露的机制，与白人城市成年人潜在的睡眠时间和质量改善有关。
