(P17-052-23) Vitamin D Status and Metabolic Health in Children and Adolescents in Southern India

Objectives: To examine vitamin D status and its associations with metabolic outcomes in children and adolescents in Southern India.

Methods: Participants included children and adolescents (6-19y) enrolled in a cohort study in Bangalore, India. Serum 25-hydroxy-vitamin D3 (25[OH]D; n=497; ECLIA), HbA1c, and lipid profile were measured. Anthropometric (weight, height, waist circumference (WC)) measurements were determined in triplicate. Body composition was measured using BODPOD. Body mass index-for-age z-score (BMIZ) was calculated and defined using World Health Organization Child Growth Standards. Elevated WC and percent body fat were defined as ≥75^th percentile, based on age- and sex-specific percentiles developed for this population. Elevated waist-to-height ratio (WHtR) was defined as ≥0.5. Vitamin D deficiency and insufficiency were defined as serum 25[OH]D < 30 nmol/L and < 50 nmol/L, respectively.

Linear and binomial regression models were used to examine associations of vitamin D status with metabolic outcomes. 

Results: A total of 48% of children had 25[OH]D  < 30 nmol/L, and 92.7% had 25[OH]D < 50 nmol/L. 17.8% of children were overweight or obese (BMIZ >+1); 25.5% had elevated WC, 18.8% had elevated WHtR; 29.8% had HbA1≥5.7%, and 18.1% had total cholesterol ≥170 mg/dL. Higher continuous vitamin D concentrations were associated with lower BMIZ (β[SE]: -0.41[0.16], p=0.011), WC (-3.01[1.30], p=0.021), WHtR (-0.08[0.03], p=0.004), body fat % (-3.65[1.06], p=0.001), total cholesterol (-9.45[3.06], p=0.002), and LDL cholesterol (-6.52[2.50], p=0.009). Similarly, vitamin D deficiency was associated with higher BMIZ (β[SE]: 0.28[0.13], p=0.029), WC (2.13[1.01], p=0.035), WHtR (0.02[0.006], p=0.011), body fat % (2.24[0.83], p=0.007, total cholesterol (7.25[2.39], p=0.003), and LDL cholesterol (4.24[1.93], p=0.029); and increased risk of elevated WC (RR: 1.37 [95% CI: 1.00-1.87], p=0.048) and WHtR (RR: 1.52 [95% CI: 1.06-2.20], p=0.022).

Conclusions: The prevalence of vitamin D deficiency was substantial in children in this population. Lower vitamin D status was associated with adiposity indices and alterations in lipid profile. 

Funding Sources: Division of Nutrition, St John’s Research Institute; Division of Nutritional Sciences, Cornell University; Fulbright-ANID fellowship (XEPM)