Vitamin D Deficiency and Knee Osteoarthritis in Midlife Women: A Prospective Cohort Study with Annual Monitoring, Supplementation, and Menopausal Stratification

A BSTRACT Introduction: Midlife women face increased risk of knee osteoarthritis (OA), osteoporosis, and metabolic comorbidities. Vitamin D deficiency, highly prevalent in this population, may contribute to OA pathogenesis through effects on cartilage metabolism, bone remodeling, and inflammatory pathways. Addressing Vitamin D status during the menopausal transition is central to preventive care and healthy aging.