ArticleAnnals of medicine2026
Serum vitamin D and lean non-alcoholic fatty liver disease: a nonlinear 'L-shaped' association in a national cross-sectional study.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- MASLD and Bone Markers in Postmenopause: Highlighting the Critical Gap of Vitamin D Status and the Need for Targeted Supplementation Trials.Health science reports · 2026Article
- Vitamin D status, metabolic determinants, and association with MASLD: retrospective health-screening cohort mediation analysis.Frontiers in nutrition · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile the association between vitamin D and non-alcoholic fatty liver disease (NAFLD) is well-established in obese populations, its role in lean NAFLD remains controversial.
objectiveThis study aimed to investigate the potential nonlinear dose-response relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lean NAFLD by leveraging large-scale data from the National Health and Nutrition Examination Survey (NHANES).
methodsWe conducted a cross-sectional analysis of 4,201 adults with BMI < 25 kg/m
resultsInitial linear models revealed no significant association. However, subsequent nonlinear analyses uncovered a pronounced 'L-shaped' curve relationship (P-nonlinear < 0.05). A segmented regression approach identified an inflection point at 60.3 nmol/L. Notably, at serum vitamin D levels below this threshold, concentrations were significantly inversely associated with lean NAFLD risk (Odds Ratio [OR] = 0.71, 95% Confidence Interval [CI]: 0.57-0.89). Conversely, above this inflection point, the inverse association attenuated and plateaued. The robustness of this nonlinear association was corroborated by the GAM analysis.
conclusionThis large-scale study is the first to identify a significant 'L-shaped' nonlinear association between serum vitamin D and lean NAFLD, wherein the association is most potent at concentrations below approximately 60 nmol/L. This finding highlights an epidemiological inflection point and underscores the need for nonlinear approaches in future research.
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