Vitamin D status, sleep patterns, genetic susceptibility, and the risk of incident adult-onset asthma: a large prospective cohort study

Qinyu Chang; Yiqun Zhu; Guowei Zhou; Huaying Liang; Dianwu Li; Jun Cheng; Pinhua Pan; Yan Zhang

doi:10.3389/fnut.2023.1222499

Vitamin D status, sleep patterns, genetic susceptibility, and the risk of incident adult-onset asthma: a large prospective cohort study

Front Nutr. 2023 Jun 30:10:1222499. doi: 10.3389/fnut.2023.1222499. eCollection 2023.

Authors

Qinyu Chang^#^{1

2

3}, Yiqun Zhu^#^{1

2

3}, Guowei Zhou^#⁴, Huaying Liang^{1

2

3}, Dianwu Li^{1

2

3}, Jun Cheng^{5

6}, Pinhua Pan^{1

2

3

7}, Yan Zhang^{1

2

3

7}

Affiliations

¹ Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
² National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.
³ Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China.
⁴ Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁵ Department of Spine Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁶ Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
⁷ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

^# Contributed equally.

Abstract

Introduction: Vitamin D has been known to be associated with asthma, particularly in children, while the evidence among adults is limited and inconclusive. This study aimed to investigate the association between serum, vitamin D concentrations, and the incidence of adult-onset asthma and also the modified effect caused by sleep patterns and genetic risks.

Methods: A prospective cohort study with 307,872 participants aged between 37 and 73 years was conducted based on the UK Biobank, with a median follow-up of 12 years. The Cox proportional hazard model was applied to evaluate the association between vitamin D status and incident adult-onset asthma, and the modified effect was investigated by conducting stratified analysis according to sleep pattern score and genetic risk score, and subgroup analyses were performed by sex, age, BMI, and smoking status as well.

Results: Individuals with optimal vitamin D concentration were associated with 11.1% reduced risk of incident asthma compared to those participants with deficient vitamin D (HR = 0.889; 95% CI: 0.820-0.964; p = 0.005). Moreover, stratification analysis demonstrated that the protective effect of vitamin D on asthma risk was modified by sleep patterns or genetic susceptibility, with the strongest protective effect being observed in the subpopulation with a moderate sleep pattern (HR = 0.883; 95% CI: 0.797-0.977; p = 0.016) and a moderate genetic risk (HR = 0.817; 95% CI: 0.711-0.938; p = 0.004). In subgroup analyses, the protective effect of optimal vitamin D levels was only significant among men, individuals younger than 60 years of age, overweight individuals, and current or previous smokers.

Conclusion: Increased serum vitamin D levels were associated with a lower risk of incident adult-onset asthma, and this association was modified by sleep patterns and genetic predisposition to some extent.

Keywords: UK biobank; Vitamin D; asthma; genetic susceptibility; sleep behaviors.

Grants and funding

This study was supported by the Natural Science Foundation of China (No. 82100037), the National Science Foundation for Post-doctoral Scientists of China (Nos. 2021TQ0375 and 2022M713538), the Hunan Outstanding Post-doctoral Innovative Talents Program (No. 2021RC2018), the Postgraduate Scientific Research Innovation Project of Hunan Province (No. 150110027), the Fundamental Research Funds for the Central Universities of Central South University (No. 2022ZZTS0861), the Youth Foundation of Xiangya Hospital (No. 2020Q06), the Key R&D Program of Hunan Province (No. 2022SK2038), the Project Program of Central South University Graduate Education Teaching Reform (No. 2022JGB025), the Research Project on Education and Teaching Reform of Central South University (No. 2021 jy139-2), and the National Key Clinical Specialist Construction Programs of China (Grant Number z047-02).