자료유형  

 학위논문

Control Number  

0017161293

International Standard Book Number  

9798382843421

Dewey Decimal Classification Number  

641

Main Entry-Personal Name  

Guetterman, Heather.

Publication, Distribution, etc. (Imprint  

[S.l.] : Cornell University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

290 p.

General Note  

Source: Dissertations Abstracts International, Volume: 85-12, Section: A.

General Note  

Advisor: Mehta, Julia.

Dissertation Note  

Thesis (Ph.D.)--Cornell University, 2024.

Summary, Etc.  

요약Background: Adequate vitamin B12 and folate status during the periconceptional period is important for preventing anemia and neural tube defects (NTD). However, there is limited population-level data on vitamin B12 and folate biomarkers and health outcomes in women of reproductive of age to inform public health screening and interventions. A population-based biomarker survey was conducted among women in Southern India to inform a randomized efficacy trial of quadruple-fortified salt (QFS; iron, iodine, folic acid, vitamin B12).Methods: Participants (n=980 women 15-40y; not pregnant or lactating) in the biomarker survey were assessed for total vitamin B12 (chemiluminescence), holotranscobalamin (enzyme-immunoassay), methylmalonic acid and homocysteine (GC-MS), red blood cell (RBC) and serum folate (WHO-recommended microbiologic assay), and HbA1c (nephelometry). A random subset (n=250) of archived urine samples were assessed for total arsenic (ICP-MS) and creatinine (enzymatic chemistry analyzer). Anthropometric and blood pressure measurements were collected in triplicate. Bioelectrical impedance analysis was used to evaluate whole body and trunk fat. Linear and binomial regression were used to examine associations of vitamin B12 status with metabolic outcomes and urinary total arsenic with micronutrient biomarkers. A previously developed Bayesian model and RBC folate and arsenic distributions in this population were used to predict NTD prevalence per 10,000 births. The acceptability of QFS was conducted among women 18-49y (n=77) and their households using a household-level randomized crossover trial (weighed salt use, hedonic ratings) and individual-level triangle tests. Mixed models were used to examine hedonic ratings and salt use; salt type, sequence, and period were included as fixed effects, and household was included as a random effect. Binomial tests were used to evaluate sensory discrimination of salt type in triangle tests among women.Results: One-third of women had overweight (body mass index≥25.0 kg/m2), 20.8% had elevated waist-to-hip ratio (≥0.85), one-fourth had elevated HbA1c (≥5.7%), and 18.6% had hypertension. Lower vitamin B12 status was associated with indicators of central adiposity, overweight, and elevated percent body fat. Urinary arsenic concentrations were detectable in all samples; 80% of women had urinary arsenic 10 µg/g while 50 µg/g. Women with urinary arsenic 10 µg/g had significantly lower RBC folate concentrations and higher predicted NTD prevalence, compared to women with concentrations ≤10 µg/g. Mean hedonic ratings and weighed household salt use did not differ by salt type and significantly increased over the 3-week period, indicating a period effect independent of salt type or sequence. In triangle tests, food samples prepared with QFS, DFS, or iodized salt were not distinguishable.Conclusions: Vitamin B12 deficiency was associated with central adiposity and overweight. Arsenic exposure at levels similar to the United States may modify RBC folate concentrations and population-level NTD risk. These data suggest an opportunity for informing public health screening and interventions. Findings informed a randomized trial of QFS in this population.

Subject Added Entry-Topical Term  

Nutrition.

Subject Added Entry-Topical Term  

Womens studies.

Subject Added Entry-Topical Term  

Biochemistry.

Subject Added Entry-Topical Term  

Obstetrics.

Index Term-Uncontrolled  

Folate status

Index Term-Uncontrolled  

Southern India

Index Term-Uncontrolled  

Periconceptional period

Index Term-Uncontrolled  

Vitamin B12

Index Term-Uncontrolled  

Urinary arsenic

Added Entry-Corporate Name  

Cornell University Nutrition

Host Item Entry  

Dissertations Abstracts International. 85-12A.

Electronic Location and Access  

로그인을 한후 보실 수 있는 자료입니다.

Control Number  

joongbu:658467