老年人群维生素D水平及睡眠状态与心血管疾病风险的队列研究  

The association of vitamin D levels and sleep status with cardiovascular disease among the elderly:a cohort study

作　　者：李聪 高永红[1] 章隽[1] 王杏芬[1] 赵洲 连雪梅 任菁[2] 李海瑜 王郑芳[2] 李薇薇 乔溪莹[4] LI Cong;GAO Yonghong;ZHANG Jun;WANG Xingfen;ZHAO Zhou;LIAN Xuemei;REN Jing;LI Haiyu;WANG Zhengfang;LI Weiwei;QIAO Xiying(Department of Cadre Medical,Beijing Aerospace General Hospital,Beijing,100076,China;Health Management Center,Beijing Aerospace General Hospital;Donggaodi Community Health Center,Beijing Aerospace General Hospital;Department of Pharmacy,Huguo Temple Chinese Medicine Hospital Affiliated to Beijing University of Chinese Medicine)

机构地区：[1]北京航天总医院干部医疗(老年医学)科,北京100076 [2]北京航天总医院健康体检中心 [3]北京航天总医院东高地社区卫生服务中心 [4]北京中医药大学附属护国寺中医医院药剂科

出　　处：《临床心血管病杂志》2022年第12期975-979,共5页Journal of Clinical Cardiology

摘　　要：目的探讨老年人群的维生素D水平及睡眠状态与心血管疾病的关联。方法基于前瞻性队列研究,于2016年8月—2020年7月招募年龄大于60岁的体检老人7837人,每年随访1次,平均随访3年。基线时志愿者做一份结构化问卷,并采集静脉血检测维生素D水平。睡眠状态由5个睡眠问题组成,包括持续时间、睡眠类型、失眠、打鼾和白天过度嗜睡,分为好、中、差3组。结局指标为脑卒中、心肌梗死、冠心病等心血管疾病。结果本研究人群,平均年龄为(68.86±14.16)岁,心血管疾病发生率为12.0%。睡眠状态好、中、差的比例分别为23.1%、63.6%和13.3%。与维生素D严重缺乏组比较,维生素D轻度缺乏组(HR=0.56,95%CI:0.48,0.66)及非缺乏组(HR=0.41,95%CI:0.34,0.51)心血管疾病发生风险较低。睡眠状态差可增加心血管疾病发生风险。维生素D水平与睡眠状态存在交互作用(P=0.002),在维生素D严重缺乏人群中,与睡眠状态差组比较,睡眠状态中等组(HR=0.64,95%CI:0.47,0.88)及睡眠状态好组(HR=0.36,95%CI:0.23,0.54)心血管疾病发生风险较低,而在维生素D非缺乏人群中未发现这种关联。结论高维生素D水平及健康的睡眠可降低老年人群的心血管疾病发生风险,较高的维生素D水平可减弱不健康睡眠所带来的危害。Objective To investigate the association of vitamin D levels and sleep status with cardiovascular disease in an elderly population.Methods Based on a prospective cohort study,7837 seniors attending medical examinations aged>60 years were recruited from August 2016 to July 2020 and followed up once a year for a mean follow-up period of 3 years.Volunteers were given a structured questionnaire at baseline and venous blood was collected for vitamin D levels.Sleep status consisted of five sleep problems,including sleep duration,chronotype,insomnia,snoring,and daytime sleepiness,divided into three groups:healthy,moderate,and poor.The outcomes were stroke,myocardial infarction,and coronary artery disease.Results In this study population,the mean age was(68.86±14.16)years and the incidence of cardiovascular disease was 12.0%.The percentage of healthy,moderate,and poor sleep status was 23.1%,63.6%,and 13.3%,respectively.The risk of cardiovascular disease was lower in the mild vitamin D deficient group(HR=0.56,95%CI:0.48,0.66)and the non-deficient group(HR=0.41,95%CI:0.34,0.51)compared with the severe vitamin D deficient group.The risk of cardiovascular disease was higher in the poor sleep status group.There was an interaction between vitamin D levels and sleep status(P=0.002),with a lower risk of cardiovascular disease in the moderate sleep status group(HR=0.64,95%CI:0.47,0.88)and the healthy sleep status group(HR=0.36,95%CI:0.23,0.54)compared with the poor sleep status group in the severe vitamin D deficient population,and in the no such association was found in the vitamin D non-deficient group.Conclusion High vitamin D levels and healthy sleep reduce the risk of cardiovascular disease in the elderly population,and higher levels of vitamin D attenuate the adverse effects of unhealthy sleep.

关 键 词：睡眠 维生素D 老年人 心血管疾病 

分 类 号：R543[医药卫生—心血管疾病]