{
  "abstract": "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 (<20 ng/mL), insufficient (20-29.9 ng/mL), and sufficient (≥30 ng/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 ng/mL decrease in serum 25(OH)D was independently associated with higher SII (β=0.064, 95% CI 0.023-0.105; p = 0.002) and higher atherogenic index of plasma (AIP; β=0.031, 95% CI 0.009-0.053; p = 0.006). The indirect association through SII accounted for 26.5% of the total association between 25(OH)D and AIP (bootstrap 95% CI 12.8-43.1). 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 ng/mL and 19.6 ng/mL, respectively. Estimates were similar in overlapping laboratory subgroups, but the indirect association was not significant in men (19.2%, 95% CI -7.6 to 39.4) or after exclusion of patients with severe deficiency (<10 ng/mL), although formal testing showed no significant interaction with sex. In a sensitivity analysis for unmeasured mediator-outcome confounding, the indirect association was reduced to zero at a residual correlation of only ρ=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 ng/mL suggests that the inflammatory-atherogenic phenotype may become more pronounced below this threshold.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Türkiye."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hüseyin Avni Fındıklı"
    },
    {
      "affs": [
        0
      ],
      "name": "Vehbi Şirikçi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4crjz31t25czy.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1884708",
  "fulltext_url": "https://europepmc.org/articles/PMC13677915",
  "id": "4crjz31t25czy",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898554",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Vitamin D Research Studies"
    ]
  ],
  "openalex": "W7220460341",
  "pdf_url": "https://europepmc.org/articles/PMC13677915?pdf=render",
  "pmcid": "PMC13677915",
  "pmid": "42898554",
  "published": "2026-10-05",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4crjz31t25czy.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42898554",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898554"
    },
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1884708",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1884708/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "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.",
  "title_text": "Serum 25-hydroxyvitamin D, systemic immune-inflammation index, and atherogenic index of plasma in statin-untreated type 2 diabetes: a cross-sectional mediation analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/4crjz31t25czy",
  "venue": "Frontiers in cardiovascular medicine",
  "versions": []
}