ArticleFrontiers in nutrition2026
Serum 25(OH)D3 and advanced liver fibrosis in type 2 diabetes: a Chinese hospital cohort with NHANES validation and mortality follow-up.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Liver fibrosis is an important predictor of mortality in patients with type 2 diabetes mellitus (T2DM). Current clinical practice relies on total 25-hydroxyvitamin D, which does not distinguish between its two main circulating isoforms, 25(OH)D2 and 25(OH)D3, although these metabolites may differ in their associations with liver fibrosis and long-term prognosis. Methods: We analyzed two independent T2DM cohorts: hospitalized Chinese patients with T2DM ( Results: In both cohorts, lower serum 25(OH)D3 was non-linearly associated with a higher risk of advanced liver fibrosis. By contrast, 25(OH)D2 showed no protective association; in NHANES, the highest tertile was associated with a higher risk of NFS-defined fibrosis (OR = 1.41, Conclusion: Lower serum 25(OH)D3, but not 25(OH)D2, was associated with advanced liver fibrosis in T2DM after multivariable adjustment. Among participants with advanced fibrosis, lower 25(OH)D3 was also associated with higher cardiovascular mortality, although cause-specific estimates based on sparse events were exploratory. These findings may support further investigation of isoform-specific 25(OH)D3 assessment for risk stratification in this population.
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