(P18-045-23) Association of Vitamin B12 Status With Body Composition and Metabolic Risk Factors in Children From Southern India

Objectives: To evaluate the burden of vitamin B₁₂ deficiency and the associations of vitamin B₁₂ status with body composition and metabolic risk factors in children from Southern India.

Methods: Anthropometry (weight, height, waist circumference, (WC)) and body composition (BOD POD, Cosmed, Italy) were measured along with Vitamin B₁₂ concentrations (chemiluminescence) and lipid profile (Cholestech LDX) of children (n = 497; aged 6-19y), in a randomly selected subset of a longitudinal cohort study in urban Bengaluru, India. Body mass index-for-age z-scores (BMIZ score) were calculated using WHO Child Growth Standards. WC and % body fat were categorized as ³75th percentile, based on age- and sex-specific percentiles derived from this population; higher waist-to-height ratio (WHtR) was defined as ≥0.5. Vitamin B₁₂ deficiency and insufficiency were defined as < 148 and < 221 pmol/L, respectively. Vitamin B₁₂ concentrations were natural logarithmically transformed for analyses. Linear and log binomial regression models were performed to examine associations of vitamin B₁₂ status with continuous and categorical outcomes.

Results: A total of 24.1% of children had vitamin B₁₂ deficiency, and 51.7% had vitamin B₁₂ insufficiency; 17.9% were overweight/obese (BMIZ >+1) and 25.5% had higher WC. Higher vitamin B₁₂ concentrations were significantly associated with lower BMIZ score (β[SE]: -0.30 [0.13], p=0.020), WC (-5.16 [1.00], p< 0.001), WHtR (-0.01 [0.01], p=0.010), % body fat (-2.50 [0.83], p=0.003), and higher HDL cholesterol (4.17 [1.03] p< 0.001). Vitamin B12 deficient children had increased risk of elevated BMIZ score [Risk Ratio (RR) 1.51 95% C.I. (1.02,2.25), p=0.037], WC (RR: 1.52 [95% CI: 1.10-2.09], p=0.011) and WHtR (RR: 1.56 [95% CI: 1.07-2.28], p=0.021). Similarly, children with vitamin B12 < 221 pmol/L had higher BMIZ score (RR: 2.03 [95% CI: 1.35-3.06], p=0.001), WC (RR: 1.77 [1.27-2.46], p< 0.001), WHtR (RR: 2.04 [95% CI: 1.36, 3.05], p< 0.001), and % body fat (RR: 1.33 [1.01-1.76] p=0.040).

Conclusions: The prevalence of vitamin B₁₂ deficiency in children was high in this population. Lower vitamin B₁₂ status was associated with increased BMI and central adiposity.

Funding Sources: Division of Nutrition, St John’s Research Institute; Division of Nutritional Sciences, Cornell University