VITAMIN D AND METABOLIC HEALTH IN WOMEN OF REPRODUCTIVE AGE, CHILDREN, AND ADOLESCENTS
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Background: Vitamin D deficiency has been associated with adverse metabolic health inclinical populations. However, data from population-based studies in women of reproductive age and children are limited. The aims of this dissertation were to examine the burden of vitamin D status and its association with metabolic health outcomes in women of reproductive age, pregnant women, and children and adolescents in Southern India. Methods: Participants from three parent cohorts were assessed for vitamin D status (25(OH)D, <30 nmol/L and <50 nmol/L) in archived samples. Metabolic health outcomes were defined for women of reproductive age, children, and adolescents. Linear and binomial regressions were used to examine associations between vitamin D status with continuous and categorical outcomes, respectively. Results: The prevalence of vitamin D deficiency was substantial in all three populations (<50 nmol/L; 65.8% in women of reproductive age; 85.0% in pregnant women (first prenatal visit); and 92.8% in children and adolescents). Lower vitamin D status was associated with increased central adiposity and overweight in women of reproductive age. In pregnant women, low vitamin D status was high early in gestation and persisted across pregnancy, and it was associated with lower infant head circumference and higher ponderal index. In children and adolescents, lower vitamin D status was associated with overweight, central adiposity, and higher DBP and lipid parameters. Conclusions: The burden of vitamin D deficiency was substantial in women of reproductive age, children, and adolescents across these three cohorts in Southern India. Lower vitamin D status was associated with increased central adiposity and overweight. Examining vitamin D and metabolic indicators prospectively could inform screening and interventions to improve the health of women and children.