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Association of Sleep Traits and Heel Bone Mineral Density: Observational and Mendelian Randomization Studies
Chinese Univ Hong Kong, Fac Med, Dept Psychiat, Li Chiu Kong Family Sleep Assessment Unit, Hong Kong, Peoples R China..ORCID iD: 0000-0001-7942-5367
Chinese Univ Hong Kong, Fac Med, Dept Psychiat, Li Chiu Kong Family Sleep Assessment Unit, Hong Kong, Peoples R China.;Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Guangdong Mental Hlth Ctr, Guangzhou, Guangdong, Peoples R China.;Southern Med Univ, Sch Clin Med 2, 253 Ind Ave Middle, Guangzhou, Peoples R China..
Chinese Univ Hong Kong, Fac Med, Cheung Res Ctr Management Parkinsonism, Sch Biomed Sci,Dept Psychiat,KIZ CUHK Joint Lab B, Hong Kong, Peoples R China..
Chinese Univ Hong Kong, Fac Med, Dept Psychiat, Li Chiu Kong Family Sleep Assessment Unit, Hong Kong, Peoples R China..
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2021 (English)In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 36, no 11, p. 2184-2192Article in journal (Refereed) Published
Abstract [en]

Observational studies have suggested that sleep and circadian disturbances are potentially modifiable risk factors for low bone mineral density (BMD), but the causal relationship is unclear. This study aimed to (i) replicate the findings by examining observational association of sleep traits with low estimated BMD); (ii) examine whether these associations were causal by using Mendelian randomization (MR) analyses; and (iii) investigate potential modulation effects of sex and menopause. A total of 398,137 White British subjects (aged 39 to 73 years) with valid BMD estimated by quantitative ultrasound of the heel (eBMD) at baseline were included. Linear regression analyses and inverse-variance weighted method were used as main methods for observational and one-sample MR analyses, respectively, to investigate the associations between self-reported sleep traits (sleep duration, chronotype, daytime sleepiness, and insomnia) and low eBMD. Furthermore, sensitivity analyses were performed in subgroups based on sex and menopause in both observational and MR analyses. In observational analyses, short/long sleep, insomnia, and definite eveningness were associated with low eBMD (short sleep: beta = -0.045, effect in standard deviation change of rank-based inverse normally transformed eBMD; long sleep: beta = -0.028; sometimes insomnia: beta = -0.012; usually insomnia: beta = -0.021; definite eveningness: beta = -0.047), whereas definite morningness was associated with decreased risk of low eBMD (beta = 0.011). Subgroup analyses suggested associations of short/long sleep and definite eveningness with low eBMD among men, short sleep with low eBMD among premenopausal women, and short sleep, eveningness, and daytime sleepiness among postmenopausal women. In bidirectional MR analyses, there was no causal relationship between sleep traits and eBMD in either overall sample or subgroup analyses. In summary, although observational analysis showed a robust association of low eBMD with sleep duration, chronotype, and insomnia, there was no evidence of causal relationship as suggested by MR analysis.

Place, publisher, year, edition, pages
Wiley John Wiley & Sons, 2021. Vol. 36, no 11, p. 2184-2192
Keywords [en]
HEEL BONE MINERAL DENSITY, MENDELIAN RANDOMIZATION, SLEEP TRAITS, UK BIOBANK
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-469834DOI: 10.1002/jbmr.4406ISI: 000672315200001PubMedID: 34184784OAI: oai:DiVA.org:uu-469834DiVA, id: diva2:1645716
Funder
Åke Wiberg Foundation, M17-0088Åke Wiberg Foundation, M18-0169Fredrik och Ingrid Thurings Stiftelse, 2017-00313Fredrik och Ingrid Thurings Stiftelse, 2018-00365Swedish Society for Medical Research (SSMF), P18-0084Available from: 2022-03-18 Created: 2022-03-18 Last updated: 2024-01-15Bibliographically approved

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