{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T16:40:42Z","timestamp":1790527242640,"version":"4.1.0"},"reference-count":102,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Chronic low-grade inflammation and nutritional deficiencies, particularly vitamin D deficiency, have emerged as important contributors to Metabolic syndrome (MetS) pathogenesis but remain underexplored. This study aimed to comprehensively evaluate the associations between dietary intake, vitamin D status, and inflammatory biomarkers (high-sensitivity C-reactive protein -CRP- and ferritin) in patients with MetS. Methods: A cross-sectional observational study was conducted on 141 adult MetS patients at a Mexican hospital. Clinical, anthropometric, dietary (using a validated food frequency questionnaire), and biochemical data including serum 25-hydroxyvitamin D, CRP, ferritin, and neutrophil-to-lymphocyte ratio (NLR) were collected. Vitamin D deficiency was defined as serum 25(OH)D &lt; 20 ng\/mL, and high inflammation as CRP \u2265 3 mg\/L. Logistic regression models adjusted for confounders were used to analyze associations. Mediation analysis assessed whether vitamin D deficiency mediated the link between dietary intake and high CRP or ferritin. Results: Patients with elevated CRP had significantly lower serum vitamin D levels (14.0 \u00b1 5.1 vs. 22.1 \u00b1 7.0 ng\/mL; p &lt; 0.001). Multivariable analysis showed vitamin D deficiency (adjusted OR 7.1; 95% CI 2.5\u201319.4; p &lt; 0.001) and hyperferritinemia (ferritin \u2265 200 \u03bcg\/L; aOR 8.0, 95% CI 3.5\u201318.2, p &lt; 0.001) as predictors of high CRP. Conversely, hyperferritinemia was predicted by vitamin D deficiency (aOR 24.69; 95% CI 3.76\u2013162.16; p = 0.001), elevated CRP (aOR 5.06; p = 0.014), Hb (aOR 63.23; p &lt; 0.001), and inversely by grade 2 obesity (aOR 0.11; 95% CI 0.02\u20130.60; p = 0.03), confirming bidirectional CRP-ferritin associations and hyperferritinemia as an inflammation marker rather than iron overload indicator. Although Hb &gt; 14.3 g\/dL associated with hyperferritinemia, it did not independently predict CRP in multivariate analyses. Frequent consumption of vitamin D-rich foods (milk, fish, Manchego and Oaxaca cheese) was associated with lower inflammation. Mediation analysis confirmed that vitamin D deficiency mediated dietary intake-CRP and dietary intake-ferritin links (Sobel test p &lt; 0.05). Conclusions: Vitamin D deficiency is a key mediator linking inadequate dietary vitamin D intake to systemic inflammation in MetS. Nutritional strategies emphasizing vitamin D repletion and consumption of vitamin D fortified foods may effectively reduce chronic inflammation and improve metabolic outcomes.<\/jats:p>","DOI":"10.3390\/nu18020224","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T07:30:34Z","timestamp":1768203034000},"page":"224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vitamin D Deficiency Mediates the Link Between Dietary Patterns, Inflammatory Biomarkers, and Iron Status Indicators (Ferritin and Hemoglobin) in Metabolic Syndrome"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3873-294X","authenticated-orcid":false,"given":"Salma I.","family":"Cortes-\u00c1lvarez","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9848-862X","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Delgado-Enciso","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"},{"name":"Colima State Institute of Cancerology, IMSS-Bienestar, Colima 28085, Mexico"},{"name":"Research Center in Minority Institutions, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4685-3095","authenticated-orcid":false,"given":"Gustavo A.","family":"Hern\u00e1ndez-Fuentes","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"},{"name":"Colima State Institute of Cancerology, IMSS-Bienestar, Colima 28085, Mexico"},{"name":"Faculty of Chemical Sciences, University of Colima, Coquimatlan 28400, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6727-0051","authenticated-orcid":false,"given":"Jos\u00e9","family":"Guzm\u00e1n-Esquivel","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Colima 28984, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3295-4768","authenticated-orcid":false,"given":"Janet","family":"Diaz-Martinez","sequence":"additional","affiliation":[{"name":"Research Center in Minority Institutions, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-0224","authenticated-orcid":false,"given":"Alejandrina","family":"Rodr\u00edguez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-9068","authenticated-orcid":false,"given":"Margarita L.","family":"Martinez-Fierro","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5988-4168","authenticated-orcid":false,"given":"Iram P.","family":"Rodr\u00edguez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Molecular and Structural Physiology Laboratory, School of Biological Sciences, Universidad Aut\u00f3noma de Nuevo Le\u00f3n, San Nicol\u00e1s de los Garza 66455, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0869-6394","authenticated-orcid":false,"given":"Valery","family":"Melnikov","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunue","family":"Flores-Ruelas","sequence":"additional","affiliation":[{"name":"Institute of Human Nutrition, University Center for Health Sciences, University of Guadalajara, Salvador Quevedo y Zubieta No. 750, Hospital Civil de Guadalajara, Annex Building, 3rd Floor, Independencia Neighborhood, Guadalajara 44340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6307-1696","authenticated-orcid":false,"given":"Idalia","family":"Garza-Veloz","sequence":"additional","affiliation":[{"name":"Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam De la","family":"Cruz-Ruiz","sequence":"additional","affiliation":[{"name":"Oficina de Investigaci\u00f3n en Salud, Servicios de Salud del Instituto Mexicano del Seguro Social Para el Bienestar (IMSS-BIENESTAR), Colima 28085, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9690-608X","authenticated-orcid":false,"given":"\u00c1ngel A.","family":"Ramos-Organillo","sequence":"additional","affiliation":[{"name":"Faculty of Chemical Sciences, University of Colima, Coquimatlan 28400, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-7821","authenticated-orcid":false,"given":"Carmen A.","family":"S\u00e1nchez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100335","DOI":"10.1016\/j.focha.2023.100335","article-title":"Metabolic Syndrome: Risk Factors, Diagnosis, Pathogenesis, and Management with Natural Approaches","volume":"3","author":"Mohamed","year":"2023","journal-title":"Food Chem. 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