维生素D水平与儿童青少年睡眠的关联

彭婵; 李凡; 李艳艳; 李妍; 熊静帆; 姚平

doi:10.16835/j.cnki.1000-9817.2025050

维生素D水平与儿童青少年睡眠的关联

doi: 10.16835/j.cnki.1000-9817.2025050

彭婵¹,
李凡¹,
李艳艳²,
李妍²,
熊静帆²,
姚平^{1, 3, ,}

1.
石河子大学医学院预防医学系，新疆 832000
2.
深圳市慢性病防治中心儿童青少年慢性病防控科
3.
华中科技大学同济医学院公共卫生学院

基金项目:

深圳市基础研究资助项目 KCXFZ20201221173400002

深圳医学重点学科建设经费资助项目 SZXK065

深圳市“医疗卫生三名工程”项目 SZSM202311020

广东省医学科学技术研究基金项目 A2024150

详细信息

作者简介:
彭婵(1997-)，女，湖北仙桃人，在读硕士，主要研究方向为营养与食品卫生

通讯作者:
姚平，E-mail：yaoping@mails.tjmu.edu.cn

中图分类号: R179 Q428 R591.44
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-23
- 修回日期: 2024-12-08
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Association between vitamin D levels and sleep in children and adolescents

PENG Chan¹,
LI Fan¹,
LI Yanyan²,
LI Yan²,
XIONG Jingfan²,
YAO Ping^{1, 3
, ,}

1.
Department of Preventive Medicine, Shihezi University Medical School, Shihezi (832000), Xinjiang Uygur Autonomous Region, China

摘要

摘要: 目的探讨儿童青少年维生素D水平与睡眠的关联，为促进儿童青少年睡眠健康提供参考。方法于2021年10—12月采用多阶段整群随机抽样方法选取深圳市4 827名6~17岁中小学生为研究对象，通过面对面问卷调查方式获取学生个人基本信息、家庭信息、生活行为方式信息及睡眠情况，并采集学生晨间空腹静脉血检测血清中25(OH)D水平。使用二元Logistic回归模型分析血清维生素D水平与睡眠特征的关系，并按性别进行分层分析。结果儿童青少年维生素D不足率为41.1%，睡眠缺乏率为19.4%。随着维生素D水平的上升，儿童青少年每天睡眠时长有增加趋势(r=0.10，P<0.01)。调整性别、年龄等协变量后，二元Logistic回归分析发现维生素D水平不足的儿童青少年更容易出现睡眠缺乏、社交时差以及学习日晚睡[OR值(95%CI)分别为1.32(1.12~1.56), 1.35(1.19~1.54)，1.26(1.05~1.52)，P值均<0.05]。性别分层分析显示，男生维生素D水平不足与睡眠不足、社交时差以及学习日与周末晚睡存在相关性[OR值(95%CI)分别为1.42(1.14~1.77)，1.25(1.04~1.49)，1.39(1.06~1.82)，1.86(1.19~2.92)]，而女生仅发现血清维生素D水平与社交时差存在关联(OR=1.47，95%CI=1.21~1.79)(P值均<0.05)。结论维生素D与儿童青少年多个维度的睡眠特征存在相关性，且该相关性在男生中更为显著。
- 维生素D /
- 睡眠 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To explore the association between vitamin D levels and sleep in children and adolescents, so as to provide a reference for promoting the sleep health of children and adolescents. Methods From October to December, 2021, 4 827 primary and middle school students aged 6-17 in Shenzhen were selected by multistage cluster random sampling method, and their demographic information, family background, lifestyle and sleep status were obtained by face-to-face questionnaire survey, and their fasting venous blood in the morning was collected to detect the serum 25(OH)D level. The relationship between serum vitamin D level and sleep characteristics was analyzed by binary Logistic regression, and stratified analysis was carried out according to gender. Results The proportion of vitamin D deficiency was 41.1%, and the proportion of sleep deficiency was 19.4%. With the increase of vitamin D level, daily sleep duration of children and adolescents tended to increase (r=0.10, P<0.01). After adjusting for covariates such as gender and age, it was found that children and adolescents with insufficient vitamin D levels were more likely to experience sleep insufficiency, social jetlag, and late sleep on weekdays, with ORs being 1.32(95%CI=1.12-1.56), 1.35(95%CI=1.19-1.54), and 1.26(95%CI=1.05-1.52)(P<0.05). Sex-stratified analysis showed that, among boys, vitamin D deficiency was associated with sleep deficiency, social jetlag, and late bedtime on weekdays and weekends[OR(95%CI)=1.42(1.14-1.77), 1.25(1.04-1.49), 1.39(1.06-1.82), 1.86(1.19-2.92), P<0.05]. In girls, however, serum vitamin D levels were only associated with social jetlag with OR being 1.47 (95%CI=1.21-1.79, P<0.05). Conclusion Vitamin D levels are associated with various sleep characteristics in children and adolescents, with this association being more pronounced among boys.
- Vitamin D /
- Sleep /
- Regression Analysis /
- Child /
- Adolescent

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表 1 不同组别儿童青少年血清维生素D水平不足率比较

Table 1. Comparison of deficiency rates of vitamin D in children and adolescents in different groups

组别	选项	人数	不足人数	χ²值	P值	组别	选项	人数	不足人数	χ²值	P值
性别	男	2 679	900(33.6)	140.17	<0.01	饮酒	是	891	493(55.3)	91.39	<0.01
	女	2 148	1 084(50.5)				否	3 936	1 491(37.9)
年龄/岁	6~12	2 890	805(27.9)	522.09	<0.01	睡眠缺乏	是	937	496(52.9)	67.25	<0.01
	13~17	1 937	1 179(60.9)				否	3 890	1 488(38.3)
家庭年收入/万元	<12	1 254	584(46.6)	29.65	<0.01	社交时差	有	2 457	1 206(49.1)	131.71	<0.01
	12~25	1 620	678(41.9)				无	2 370	778(32.8)
	>25	1 953	722(37.0)			学习日晚睡	是	3 913	1 724(44.1)	74.60	<0.01
看护者	父母	3 856	1 645(42.7)	19.24	<0.01		否	914	260(28.4)
	其他	971	339(34.9)			周末晚睡	是	4 538	1 908(42.0)	27.83	<0.01
看护者学历	初中以下	1 029	451(43.8)	21.88	<0.01		否	289	76(26.3)
	高中	1 083	495(45.7)			难以入睡	是	1 528	682(44.6)	11.52	<0.01
	大专以上	2 715	1 038(38.2)				否	3 299	1 302(39.5)
季节	秋	3 390	1 204(35.5)	146.77	<0.01	打鼾	是	818	309(37.8)	4.50	0.03
	冬	1 437	780(54.3)				否	4 009	1 675(41.8)
是否补充维生素D	是	693	198(28.6)	52.48	<0.01	张口呼吸	是	1 219	497(40.8)	0.07	0.79
	否	4 134	1 786(43.2)				否	3 608	1 487(41.2)
每周早餐天数	≥5	4 762	1 940(40.7)	19.24	<0.01	憋气	是	108	53(49.1)	2.90	0.09
	＜5	65	44(67.7)				否	4 719	1 931(40.9)
每天运动时长/h	＜0.5	1 346	646(48.0)	43.35	<0.01	流口水	是	960	403(42.0)	0.38	0.54
	0.5~1.0	2 216	888(40.1)				否	3 867	1 581(40.9)
	＞1.0	1 265	450(35.6)			晨醒困难	是	1 265	479(37.9)	7.42	0.01
每天户外运动时长/h	＜1	3 269	1 415(43.3)	19.94	<0.01		否	3 562	1 505(42.3)
	≥1	1 558	569(36.5)			白天犯困	是	1 121	667(59.5)	204.16	<0.01
每天使用电子产品	≤2	4 117	1 597(38.8)	61.79	<0.01		否	3 706	1 317(35.5)
时长/h	＞2	710	387(54.5)			睡眠障碍	是	3 314	1 426(43.0)	15.97	<0.01
吸烟	是	92	44(47.8)	1.75	0.16		否	1 513	558(36.9)
	否	4 735	1 940(41.0)
注： ()内数字为不足率/%；因血清采集时间为10—12月，季节只包含秋冬两季。

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表 2 儿童与青少年睡眠情况比较(x ±s)

Table 2. Comparison of sleep conditions between children and adolescents(x ±s)

组别	人数	学习日睡眠时长/h	周末睡眠时长/h	学习日起床时间^a	周末起床时间^a	学习日睡觉时间^a	周末睡觉时间^a	学习日睡眠中点^a	周末睡眠中点^a
儿童	2 890	8.80±0.64	9.70±0.78	6：54±0.33	8：12±0.80	22：00±0.54	22：30±0.61	2：30±0.32	3：30±0.59
青少年	1 937	7.30±0.73	9.00±1.29	6：24±0.32	8：36±1.25	23：06±0.67	23：36±1.06	2：07±0.38	4：10±0.96
t值		79.67	25.12	54.63	-11.32	-60.30	-45.00	26.62	-31.65
P值		<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
注： ^a均数采用24 h制描述，标准差单位为小时数。

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表 3 儿童青少年维生素D水平与睡眠指标关联的Logistic回归分析[OR值(95%CI)]

Table 3. Logistic regression associations of vitamin D levels and sleep indices among children and adolescents[OR(95%CI)]

性别	因变量	模型1	模型2	模型3
男	睡眠缺乏	1.85(1.52~2.26)^**	1.44(1.17~1.78)^**	1.42(1.14~1.77)^**
(n=2 679)	社交时差	1.70(1.45~2.00)^**	1.30(1.10~1.55)^**	1.25(1.04~1.49)^**
	学习日晚睡	2.17(1.72~2.73)^**	1.16(0.91~1.50)	1.39(1.06~1.82)^*
	周末晚睡	2.81(1.84~4.27)^**	1.68(1.09~2.58)^*	1.86(1.19~2.92)^**
	睡眠障碍	1.25(1.05~1.50)^**	1.05(0.88~1.27)	1.04(0.86~1.26)
女	睡眠缺乏	1.82(1.47~2.27)^**	1.19(0.93~1.51)	1.21(0.94~1.55)
(n=2 148)	社交时差	2.18(1.84~2.60)^**	1.62(1.35~1.96)^**	1.47(1.21~1.79)^**
	学习日晚睡	1.86(1.49~2.33)^**	0.98(0.77~1.25)	1.17(0.90~1.52)
	周末晚睡	1.51(1.04~2.20)^*	0.93(0.63~1.37)	0.94(0.62~1.41)
	睡眠障碍	1.38(1.15~1.65)^**	1.09(0.90~1.33)	1.09(0.89~1.34)
合计	睡眠缺乏	1.82(1.57~2.10)^**	1.33(1.14~1.56)^**	1.32(1.12~1.56)^**
(n=4 827)	社交时差	1.97(1.76~2.22)^**	1.44(1.27~1.64)^**	1.35(1.19~1.54)^**
	学习日晚睡	1.98(1.69~2.32)^**	1.07(0.90~1.27)	1.26(1.05~1.52)^**
	周末晚睡	2.03(1.56~2.66)^**	1.22(0.92~1.62)	1.30(0.96~1.74)
	睡眠障碍	1.29(1.14~1.47)^**	1.08(0.94~1.23)	1.07(0.93~1.23)
注：自变量维生素D以充足为参照；模型1未调整，模型2调整性别、年龄，模型3调整性别、年龄、BMI、家庭年收入、照看人、照看人学历、季节、维生素D补充剂、早餐、每天运动时间、每天户外运动时长、每天电子产品时长、吸烟和饮酒；^* P<0.05，^** P<0.01。

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