Wang Shizhen, Zheng Dahong, Wang Hui, Wu Mengru, Xia Wangjie, Luo Zhen, Tian Li
The First Affiliated Hospital of Soochow University, Suzhou, China.
School of Nursing, Medical College of Soochow University, Suzhou, China.
Front Nutr. 2025 Apr 11;12:1514529. doi: 10.3389/fnut.2025.1514529. eCollection 2025.
Vitamin D deficiency and sleep disorders may independently contribute to increased mortality, but the combined effects of these two factors on mortality remain unknown. This study aimed to investigate both the separate and joint effects of vitamin D deficiency and sleep disorders on cardiovascular disease mortality, as well as all-cause mortality and cancer mortality.
We analyzed data from 24,566 adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Sleep disorders were assessed using self-report questionnaires, and vitamin D levels were measured through serum total 25-hydroxyvitamin D [25(OH)D]. Cox proportional hazards models were employed to evaluate the associations between separate and joint effects of vitamin D deficiency and sleep disorders with mortality outcomes.
Over a median follow-up of 9.08 years, we included a total of 24,566 individuals, in this study. Among them, 2,776 cases were all-cause deaths, 858 were cardiovascular disease deaths, and 644 were cancer deaths. We found that Vitamin D deficiency was independently associated with an increased risk of all-cause mortality, while sleep disorders were similarly associated with a higher risk of all-cause mortality. Notably, participants with both vitamin D deficiency and sleep disorders exhibited a significantly higher risk of all-cause mortality (HR, 2.31; 95% CI: 1.36-3.91) and cardiovascular mortality (HR, 2.39; 95% CI, 1.03-5.58) compared to those with only one or neither risk factor, even after adjusting for potential confounders.
Our study highlights that the combination of vitamin D deficiency and sleep disorders was associated with an increased risk of all-cause and cardiovascular mortality in adults. These findings might help to refine dietary and lifestyle intervention strategies for this population.
维生素D缺乏和睡眠障碍可能各自导致死亡率增加，但这两个因素对死亡率的综合影响尚不清楚。本研究旨在调查维生素D缺乏和睡眠障碍对心血管疾病死亡率、全因死亡率和癌症死亡率的单独及联合影响。
我们分析了2005年至2018年美国国家健康与营养检查调查（NHANES）中24566名成年人的数据。使用自我报告问卷评估睡眠障碍，通过血清总25-羟基维生素D[25(OH)D]测量维生素D水平。采用Cox比例风险模型评估维生素D缺乏和睡眠障碍的单独及联合影响与死亡率结局之间的关联。
在中位随访9.08年期间，本研究共纳入24566人。其中，全因死亡2776例，心血管疾病死亡858例，癌症死亡644例。我们发现维生素D缺乏与全因死亡率增加独立相关，睡眠障碍同样与全因死亡率较高相关。值得注意的是，与仅有一个或没有风险因素的参与者相比，同时存在维生素D缺乏和睡眠障碍的参与者即使在调整潜在混杂因素后，全因死亡率（风险比[HR]，2.31；95%置信区间[CI]：1.36 - 3.91）和心血管死亡率（HR，2.39；95%CI，1.03 - 5.58）仍显著更高。
我们的研究强调，维生素D缺乏和睡眠障碍的组合与成年人全因和心血管死亡率增加相关。这些发现可能有助于完善针对该人群的饮食和生活方式干预策略。
