{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:55:04Z","timestamp":1791179704515,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>\n                    This cross-sectional study investigated the associations between serum 25-hydroxyvitamin D [25(OH)D] levels, systemic inflammatory burden, and atherogenic lipid profile in statin-untreated adults with type 2 diabetes, with particular emphasis on the contribution of the systemic immune-inflammation index (SII). A total of 619 statin-untreated patients with type 2 diabetes were included. Participants were stratified according to serum 25(OH)D concentrations into deficient (&amp;lt;20\u2005ng\/mL), insufficient (20\u201329.9\u2005ng\/mL), and sufficient (\u226530\u2005ng\/mL) groups. Multivariable linear regression, BCa bootstrap mediation analysis with 5,000 resamples, and restricted cubic spline models were used. In fully adjusted models, each 10\u2005ng\/mL decrease in serum 25(OH)D was independently associated with higher SII (\u03b2=0.064, 95% CI 0.023\u20130.105;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) and higher atherogenic index of plasma (AIP; \u03b2=0.031, 95% CI 0.009\u20130.053;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006). The indirect association through SII accounted for 26.5% of the total association between 25(OH)D and AIP (bootstrap 95% CI 12.8\u201343.1). Indirect associations were weaker for the neutrophil-to-lymphocyte ratio and non-significant for the monocyte-to-lymphocyte and platelet-to-lymphocyte ratios. Restricted cubic spline analyses demonstrated significant non-linearity for both SII and AIP, with points of maximal curvature at 18.7\u2005ng\/mL and 19.6\u2005ng\/mL, respectively. Estimates were similar in overlapping laboratory subgroups, but the indirect association was not significant in men (19.2%, 95% CI \u22127.6 to 39.4) or after exclusion of patients with severe deficiency (&amp;lt;10\u2005ng\/mL), although formal testing showed no significant interaction with sex. In a sensitivity analysis for unmeasured mediator\u2013outcome confounding, the indirect association was reduced to zero at a residual correlation of only\n                    <jats:italic>\u03c1<\/jats:italic>\n                    =0.20, indicating limited robustness. The findings are compatible with a statistical indirect relationship involving systemic inflammation between vitamin D status and atherogenic dyslipidaemia, but the cross-sectional design precludes causal inference. The non-linear pattern near 20\u2005ng\/mL suggests that the inflammatory\u2013atherogenic phenotype may become more pronounced below this threshold.\n                  <\/jats:p>","DOI":"10.3389\/fcvm.2026.1884708","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:08Z","timestamp":1791178328000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum 25-hydroxyvitamin D, systemic immune-inflammation index, and atherogenic index of plasma in statin-untreated type 2 diabetes: a cross-sectional mediation analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"H\u00fcseyin Avni","family":"F\u0131nd\u0131kl\u0131","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Kahramanmara\u015f Necip Faz\u0131l City Hospital","place":["Kahramanmara\u015f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vehbi","family":"\u015eirik\u00e7i","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kahramanmara\u015f Necip Faz\u0131l City Hospital","place":["Kahramanmara\u015f, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e70014","DOI":"10.1111\/1753-0407.70014","article-title":"Overview of oxidative stress and inflammation in diabetes","volume":"16","author":"Weinberg Sibony","year":"2024","journal-title":"J Diabetes"},{"key":"B2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12933-023-01878-5","article-title":"Supra-additive effect of chronic inflammation and atherogenic dyslipidemia on developing type 2 diabetes among young adults: a prospective cohort 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