Serum Vitamin D, Sleep Pattern and Cardiometabolic Diseases: Findings from the National Health and Nutrition Examination Survey

Kenneth Lo; Yu-Qing Huang; Lin Liu; Yu-Ling Yu; Chao-Lei Chen; Jia-Yi Huang; Ying-Qing Feng

doi:10.2147/DMSO.S256133

Serum Vitamin D, Sleep Pattern and Cardiometabolic Diseases: Findings from the National Health and Nutrition Examination Survey

Diabetes Metab Syndr Obes. 2020 May 14:13:1661-1668. doi: 10.2147/DMSO.S256133. eCollection 2020.

Authors

Kenneth Lo^#^{1

2}, Yu-Qing Huang^#¹, Lin Liu¹, Yu-Ling Yu¹, Chao-Lei Chen¹, Jia-Yi Huang¹, Ying-Qing Feng¹

Affiliations

¹ Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, People's Republic of China.
² Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.

^# Contributed equally.

Abstract

Objective: Although poor sleep health and vitamin D deficiency may be associated with diabetes and hypertension, whether this association shows a trend depending on vitamin D concentration is unclear.

Subjects and methods: We analyzed data from 10,742 participants (4997 men) from the 2007-2014 National Health and Nutrition Examination Survey. Abnormal sleep pattern (ie, short sleep duration, sleep complaint, and/or sleep disorder), lifestyle factors, serum vitamin D level, and the status of diabetes and hypertension were assessed. Logistic regression was performed to estimate the odds ratio (OR) and 95% confidence interval (CI).

Results: Serum vitamin D significantly interacted with short sleep duration and abnormal sleep pattern (both p = 0.003) on the association with diabetes in men. Short sleep duration (OR: 1.82, 95% CI = 1.29, 2.57) and abnormal sleep pattern (OR: 1.95, 95% CI = 1.38, 2.77) were associated with diabetes in men with serum vitamin D of >75 nmol/L. Serum vitamin D significantly interacted with sleep complaint on the association with hypertension in men and women (both p < 0.05). The magnitude of association between sleep complaint and hypertension in men was stronger when serum vitamin D level was <50 nmol/L (OR: 2.26, 95% CI = 1.57, 3.25) than when the level was >75 nmol/L (OR: 1.28, 95% CI = 0.90, 1.83). Similarly, the magnitude of association between sleep complaint and hypertension in women was stronger when serum vitamin D level was <50 nmol/L (OR: 2.09, 95% CI = 1.53, 2.86) than when the level was >75 nmol/L (OR: 1.64, 95% CI = 0.98, 2.72). No significant interactions were observed between serum vitamin D level and other sleep variables.

Conclusion: Abnormal sleep pattern is associated with a high risk of diabetes and hypertension. The relationship between sleep complaint and hypertension may be strong in people with vitamin D deficiency, and this observation should be verified by prospective studies.

Keywords: diabetes; epidemiology; hypertension; sleep; vitamin D.

Grants and funding

This work was supported by the Natural Science Foundation of Guangdong Province (No. 2015A030313660), the Science and Technology Plan Project of Guangdong Province (No. 2014B020212008), the Science and Technology Program of Guangzhou (No.201604020143, No.201604020018, No.201604020186, No.201510010254, and No.201803040012), and the National Key Research and Development Program of China (No.2017FYC1307603, No.2016YFC1301305, and No.2017YFC0909303).