{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:01Z","timestamp":1788419761908,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"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. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between vitamin D and metabolic dysfunction\u2013associated steatotic liver disease (MASLD) remains controversial due to confounding by metabolic risk factors. We aimed to evaluate the association between vitamin D status and MASLD and examine the extent to which metabolic factors statistically contribute to this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this large retrospective cross-sectional health-screening cohort study, 35,468 adults (mean age 46.3\u202fyears [SD 11.8]) undergoing routine health examinations were included. Serum 25-hydroxyvitamin D [25(OH)D] levels were analysed in relation to ultrasonography-defined MASLD. Multivariable logistic regression, partial correlation, and mediation analyses were used to assess independent associations and estimate the proportion of the observed association statistically explained by metabolic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean 25(OH)D concentration was 65.4\u202fnmol\/L (SD 26.4), and MASLD prevalence was 36.1%. Higher vitamin D levels were associated with lower odds of MASLD after adjustment for age and sex (OR 0.90 [95% CI 0.89\u20130.91]) and remained significant after additional adjustment for metabolic factors (OR 0.93 [0.92\u20130.95]). In contrast, associations between vitamin D and most metabolic traits were attenuated after adjustment, indicating non-independent relationships. Mediation analysis showed that 37.6% of the observed association between vitamin D and MASLD was statistically explained by metabolic factors, predominantly triglycerides (39.2%), HDL cholesterol (14.7%), and BMI (13.0%), whereas the remaining proportion was not explained by the measured mediators included in the model. The inverse association between vitamin D and MASLD was consistent across age and sex subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Vitamin D is independently associated with lower odds of MASLD beyond traditional metabolic factors. While metabolic factors contribute to part of the observed association, the remaining association was not explained by measured metabolic factors and should not be interpreted as evidence of a causal biological pathway. These findings support further investigation of vitamin D status as an associated marker of metabolic liver health and highlight the need for prospective studies evaluating its clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1922441","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:31Z","timestamp":1788417631000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D status, metabolic determinants, and association with MASLD: retrospective health-screening cohort mediation analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Hui","family":"He","sequence":"first","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiyan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Headquarters of Shenzhen Nanshan Medical Group","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshan","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Health Management, Shenzhen People\u2019s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College, Jinan University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1002\/hep.28584","article-title":"Global epidemiology of nonalcoholic fatty liver disease: Meta-analytic assessment of prevalence, incidence, and outcomes","volume":"64","author":"Lonardo","year":"2016","journal-title":"Hepatology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"884","DOI":"10.5114\/aoms\/150639","article-title":"Non-alcoholic fatty liver disease, metabolic syndrome, and type 2 diabetes mellitus: where do we stand today?","volume":"19","author":"Mitrovic","year":"2022","journal-title":"Arch Med Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"450639","DOI":"10.1155\/2013\/450639","article-title":"Nonalcoholic fatty liver disease, diabetes mellitus and cardiovascular disease: newer data","volume":"2013","author":"Mavrogiannaki","year":"2013","journal-title":"Int J Endocrinol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"9488","DOI":"10.3748\/wjg.v22.i43.9488","article-title":"Nonalcoholic fatty liver disease - A multisystem disease?","volume":"22","author":"Mikolasevic","year":"2016","journal-title":"World J Gastroenterol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1080\/09513590601045629","article-title":"Vitamin D: the secosteroid hormone and human reproduction","volume":"23","author":"P\u00e9rez-L\u00f3pez","year":"2007","journal-title":"Gynecol Endocrinol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"214","DOI":"10.3233\/JAD-230214","article-title":"Vitamin D, a secosteroid hormone and its multifunctional receptor, vitamin D receptor, in Alzheimer\u2019s type neurodegeneration","volume":"95","author":"Gezen-Ak","year":"2023","journal-title":"J Alzheimer's Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12986-025-01011-1","article-title":"Vitamin D and bone health: from physiological function to disease association","volume":"22","author":"Liu","year":"2025","journal-title":"Nutr Metab (Lond)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1070808","DOI":"10.3389\/fnut.2023.1070808","article-title":"Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants","volume":"10","author":"Cui","year":"2023","journal-title":"Front Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1038\/s41430-020-0558-y","article-title":"Vitamin D deficiency 2.0: an update on the current status worldwide","volume":"74","author":"Amrein","year":"2020","journal-title":"Eur J Clin Nutr"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"104275","DOI":"10.1016\/j.numecd.2025.104275","article-title":"Vitamin D nutritional status in China: a multicenter cross-sectional study","volume":"36","author":"Wang","year":"2026","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1038\/s41574-021-00593-z","article-title":"The health effects of vitamin D supplementation: evidence from human studies","volume":"18","author":"Bouillon","year":"2022","journal-title":"Nat Rev Endocrinol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3302","DOI":"10.3390\/nu12113302","article-title":"Vitamin D and metabolic dysfunction-associated fatty liver disease (MAFLD): an update","volume":"12","author":"Barchetta","year":"2020","journal-title":"Nutrients"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.cell.2013.03.028","article-title":"A vitamin D receptor\/SMAD genomic circuit gates hepatic fibrotic response","volume":"153","author":"Ding","year":"2013","journal-title":"Cell"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"7389","DOI":"10.1039\/d0fo01095b","article-title":"Vitamin D and non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials","volume":"11","author":"Guo","year":"2020","journal-title":"Food Funct"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1111\/apt.12377","article-title":"Meta-analysis: vitamin D and non-alcoholic fatty liver disease","volume":"38","author":"Eliades","year":"","journal-title":"Aliment Pharmacol Ther"},{"key":"ref17","first-page":"17221","article-title":"Association between vitamin D and non-alcoholic fatty liver disease\/non-alcoholic steatohepatitis: results from a meta-analysis","volume":"8","author":"Wang","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2634463","DOI":"10.1080\/07853890.2026.2634463","article-title":"Serum vitamin D and lean non-alcoholic fatty liver disease: a nonlinear \u201cL-shaped\u201d association in a national cross-sectional study","volume":"58","author":"Ma","year":"2026","journal-title":"Ann Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1111\/liv.15046","article-title":"Changing clinical management of NAFLD in Asia","volume":"42","author":"Nakatsuka","year":"2022","journal-title":"Liver Int"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"S32","DOI":"10.3350\/cmh.2022.0365","article-title":"Global incidence and prevalence of nonalcoholic fatty liver disease","volume":"29","author":"Teng","year":"2023","journal-title":"Clin Mol Hepatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"269","DOI":"10.3349\/ymj.2024.0065","article-title":"Serum 25(OH)D levels and risk of nonalcoholic fatty liver disease in nonobese and lean individuals","volume":"66","author":"Kim","year":"2025","journal-title":"Yonsei Med J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"60","DOI":"10.14218\/ERHM.2023.00019","article-title":"Molecular crosstalk between vitamin D and non-alcoholic fatty liver disease","volume":"9","author":"Sarkar","year":"2024","journal-title":"Explor Res Hypothesis Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1419747","DOI":"10.3389\/fnut.2024.1419747","article-title":"The effects of vitamin D supplementation on serum lipid profiles in people with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials","volume":"11","author":"Lu","year":"2024","journal-title":"Front Nutr"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2532","DOI":"10.3390\/ijms27062532","article-title":"Vitamin D and metabolic dysfunction-associated Steatotic liver disease: molecular mechanisms and clinical implications\u2014A narrative review","volume":"27","author":"Fuentes-Barr\u00eda","year":"2026","journal-title":"Int J Mol Sci"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1186\/s13098-025-02031-w","article-title":"Association between vitamin D and metabolic-associated steatotic liver disease in type 2 diabetes mellitus patients: a systematic review and meta-analysis","volume":"17","author":"Basil","year":"2025","journal-title":"Diabetol Metab Syndr"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/j.clinthera.2023.07.009","article-title":"The effects of vitamin D on markers of glucose and obesity in postmenopausal women: A Meta-analysis of randomized controlled trials","volume":"45","author":"Hao","year":"2023","journal-title":"Clin Ther"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"106938","DOI":"10.1016\/j.prostaglandins.2024.106938","article-title":"The effect of vitamin D on the lipid profile in individuals with overweight or obesity: A meta-analysis and systematic review of randomized controlled trials","volume":"176","author":"Yu","year":"2025","journal-title":"Prostaglandins Other Lipid Mediat"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/1751-2980.13210","article-title":"Vitamin E supplementation in the treatment on nonalcoholic fatty liver disease (NAFLD): evidence from an umbrella review of meta-analysis on randomized controlled trials","volume":"24","author":"Wang","year":"2023","journal-title":"J Dig Dis"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1093\/nutrit\/nuaf117","article-title":"Role of vitamin D supplementation in chronic liver disease: A systematic review and Meta-analysis of randomized controlled trials","volume":"83","author":"Martinekova","year":"2025","journal-title":"Nutr Rev"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"107631","DOI":"10.1016\/j.cdnut.2025.107631","article-title":"Vitamin D supplementation for Steatotic liver disease: an updated systematic review and dose-response Meta-analysis of randomized and nonrandomized interventional studies","volume":"10","author":"Taheri","year":"2026","journal-title":"Curr Dev Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"375","DOI":"10.62347\/GMTV5559","article-title":"Association between triglyceride-glucose index and vitamin D levels in Saudi postmenopausal women: a cross-sectional study","volume":"18","author":"Yakout","year":"2025","journal-title":"Int J Clin Exp Pathol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"172","DOI":"10.3390\/biomedicines9020172","article-title":"Vitamin D and its role in the lipid metabolism and the development of atherosclerosis","volume":"9","author":"Surdu","year":"2021","journal-title":"Biomedicine"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1922441\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:32Z","timestamp":1788417632000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1922441\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":32,"alternative-id":["10.3389\/fnut.2026.1922441"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1922441","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1922441"}}