Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus

Abstract Aims The present study aimed to evaluate the effect of Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), vitamin D deficiency, and their interaction on the Left Ventricle (LV) structure and diastolic function in type 2 diabetes mellitus (T2DM) patients. Methods A total of 595 T2DM pat...

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Main Authors: Yun-Ming Li, Jia-Yi Huang, Ran Guo, Shi-Ming Li, Cong Chen, Min Wu, Run Wang, Ming-Ya Liu, Kai-Hang Yiu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01808-3
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author Yun-Ming Li
Jia-Yi Huang
Ran Guo
Shi-Ming Li
Cong Chen
Min Wu
Run Wang
Ming-Ya Liu
Kai-Hang Yiu
author_facet Yun-Ming Li
Jia-Yi Huang
Ran Guo
Shi-Ming Li
Cong Chen
Min Wu
Run Wang
Ming-Ya Liu
Kai-Hang Yiu
author_sort Yun-Ming Li
collection DOAJ
description Abstract Aims The present study aimed to evaluate the effect of Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), vitamin D deficiency, and their interaction on the Left Ventricle (LV) structure and diastolic function in type 2 diabetes mellitus (T2DM) patients. Methods A total of 595 T2DM patients were recruited and stratified according to NFS grades (low, intermediate, and high) and the level of serum 25(OH)D (with and without vitamin D deficiency). Parameters of LV structure and diastolic dysfunction were measured by echocardiography. The association between NFS and LV structure and diastolic function was assessed using multivariable linear regression models stratified by vitamin D levels. Results Left ventricular hypertrophy (LVH) was more prevalent in patients with high NFS compared to those with low and intermediate NFS (41.0 vs 14.0% and 9.0%, P < 0.001). The average E/e′ was higher in patients with intermediate and high NFS, as compared to those with low NFS. Within the high NFS group, patients with vitamin D deficiency exhibited significantly higher left ventricular mass index (LVMI) and average E/e′ compared to those without vitamin D deficiency. An interaction between vitamin D and NFS groups was found on both LVMI (P for interaction = 0.008) and average E/e′ (P for interaction = 0.001). Conclusions NFS and vitamin D deficiency are associated with an increased risk of LVH and impaired diastolic function in patients with T2DM. Notably, the impact of vitamin D deficiency on these parameters is more pronounced in individuals with a high NFS score.
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series Diabetology & Metabolic Syndrome
spelling doaj-art-69729e64ad9d40f9b73638f0b1e2ffbd2025-08-20T03:46:12ZengBMCDiabetology & Metabolic Syndrome1758-59962025-08-0117111110.1186/s13098-025-01808-3Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitusYun-Ming Li0Jia-Yi Huang1Ran Guo2Shi-Ming Li3Cong Chen4Min Wu5Run Wang6Ming-Ya Liu7Kai-Hang Yiu8Health Science Center, Shenzhen UniversityDivision of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalDivision of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen HospitalAbstract Aims The present study aimed to evaluate the effect of Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS), vitamin D deficiency, and their interaction on the Left Ventricle (LV) structure and diastolic function in type 2 diabetes mellitus (T2DM) patients. Methods A total of 595 T2DM patients were recruited and stratified according to NFS grades (low, intermediate, and high) and the level of serum 25(OH)D (with and without vitamin D deficiency). Parameters of LV structure and diastolic dysfunction were measured by echocardiography. The association between NFS and LV structure and diastolic function was assessed using multivariable linear regression models stratified by vitamin D levels. Results Left ventricular hypertrophy (LVH) was more prevalent in patients with high NFS compared to those with low and intermediate NFS (41.0 vs 14.0% and 9.0%, P < 0.001). The average E/e′ was higher in patients with intermediate and high NFS, as compared to those with low NFS. Within the high NFS group, patients with vitamin D deficiency exhibited significantly higher left ventricular mass index (LVMI) and average E/e′ compared to those without vitamin D deficiency. An interaction between vitamin D and NFS groups was found on both LVMI (P for interaction = 0.008) and average E/e′ (P for interaction = 0.001). Conclusions NFS and vitamin D deficiency are associated with an increased risk of LVH and impaired diastolic function in patients with T2DM. Notably, the impact of vitamin D deficiency on these parameters is more pronounced in individuals with a high NFS score.https://doi.org/10.1186/s13098-025-01808-3Non-alcoholic fatty liver disease fibrosis scoreVitamin D deficiencyLeft ventricular hypertrophyLeft ventricular diastolic dysfunctionType 2 diabetes mellitus
spellingShingle Yun-Ming Li
Jia-Yi Huang
Ran Guo
Shi-Ming Li
Cong Chen
Min Wu
Run Wang
Ming-Ya Liu
Kai-Hang Yiu
Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
Diabetology & Metabolic Syndrome
Non-alcoholic fatty liver disease fibrosis score
Vitamin D deficiency
Left ventricular hypertrophy
Left ventricular diastolic dysfunction
Type 2 diabetes mellitus
title Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
title_full Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
title_fullStr Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
title_full_unstemmed Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
title_short Interaction between the non-alcoholic fatty liver disease fibrosis score and vitamin D deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
title_sort interaction between the non alcoholic fatty liver disease fibrosis score and vitamin d deficiency on left ventricular hypertrophy and impaired diastolic function in patients with type 2 diabetes mellitus
topic Non-alcoholic fatty liver disease fibrosis score
Vitamin D deficiency
Left ventricular hypertrophy
Left ventricular diastolic dysfunction
Type 2 diabetes mellitus
url https://doi.org/10.1186/s13098-025-01808-3
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