Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Mayur Desai


Early age of menarche (AOM) increases risk for chronic disorders, including cardiovascular disease and related mortality, type 2 diabetes, and breast cancer. Vitamin D deficiency may be linked to earlier onset of menstruation, but there is limited research examining vitamin D and its association with AOM. The objective of this study was to examine the association between vitamin D levels and AOM by analyzing the National Health and Nutrition Examination Survey (NHANES) data from 2001-2010. We hypothesized that that vitamin D deficiency is associated with earlier age of menarche in adolescent and early adult females in the United States. Cross-sectional data on serum 25-hydroxy vitamin D (25OHD) levels and self-reported AOM were available on a sample of 3,572 females between the ages of 12-19 in the 2001-2010 NHANES. Multinomial logistic regression analysis was undertaken to estimate adjusted odds ratios (AORs) for the association between vitamin D status as reflected by serum 25OHD levels with both early (≤9 years) and late (≥14 years) AOM, with adjustment for sampling design and controlling for potential confounders (race, body mass index [BMI], socio-economic status and age at time of participation). Girls with evidence of vitamin D deficiency (serum 25OHD <50nmol/L) were nearly twice as likely to report early AOM compared with the non-vitamin D deficient population (OR: 1.89; 95% CI 1.04-3.41). On multivariable analyses, however, this association between vitamin D deficiency and early AOM no longer held after controlling for age at interview, race/ethnicity, BMI, and poverty income ratio. Racial and BMI related predisposition to early AOM were evident. There was no interaction between vitamin D and the covariates of interest with the outcome AOM. Overall, in a representative sample of the US population, vitamin D status was not associated with AOM after adjusting for potential confounders.


This is an Open Access Thesis.

Open Access

This Article is Open Access