Vitamin D and Skeletal Health: Across the Life Course

Despite an exponential growth in our knowledge over the last decade on vitamin D metabolism and its effects on skeletal health; several knowledge gaps are being identified with regards to assessing its status, response to its treatment and its functional outcome. The composition of this thesis has been chosen to ensure that role of vitamin D in skeletal health is considered from a holistic perspective across the life course ranging from antenatal period to adulthood. Whilst each chapter has its own detailed aim and objective, the overall aims and objectives for the thesis are: Aim To identify and bridge the existing knowledge gaps on ‘The Role of Vitamin D in Skeletal Health’ across the life course with regards to assessing its status, effect on postnatal bone development and response to mechanical stimulation, relationship between fractures and rickets in infants and response to its treatment in young adults. Key Objectives 1. Does antenatal vitamin D supplementation influence the postnatal response of bone to mechanical stimulation? 2. What is the relationship between Vitamin D, Rachitic Radiographic Changes and Fractures in Infants? 3. Whether standard treatment with vitamin D based on the total 25OHD levels is appropriate across all ethnic groups? Alternatively, should we adopt a personalised approach for vitamin D supplementation and treatment based on an individual’s skin colour, race and vitamin D binding protein genotype?