{
  "abstract": "Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by metabolic dysregulation and chronic inflammation, yet simple markers for mortality risk stratification remain limited. The C-reactive protein-triglyceride-glucose index (CTI) reflects metabolic-inflammatory burden, whereas serum 25-hydroxyvitamin D [25(OH)D] is a marker of vitamin D status linked to insulin resistance and vascular dysfunction. We examined the associations of CTI and 25(OH)D with all-cause and stroke-related mortality in adults with MASLD and explored the potential mediating roles of diabetes and hypertension.Methods NHANES was used as the discovery cohort of adults with MASLD, in which CTI and 25(OH)D were evaluated in relation to all-cause and stroke-related mortality. MIMIC-IV was included as a supplementary hospital-based cohort of patients with fatty liver, in which the association between CTI and all-cause mortality was examined. Survey-weighted Cox models, restricted cubic spline analyses, competing-risk models, and mediation analyses were performed.Results In NHANES, higher CTI levels were associated with increased risks of all-cause and stroke-related mortality, whereas higher 25(OH)D levels were associated with lower mortality risk. These associations remained after adjustment for demographic characteristics, lifestyle factors, metabolic comorbidities, and liver-related covariates. Dose-response relationships were observed for both markers. Mediation analyses suggested that diabetes accounted for part of the observed associations, whereas the contribution of hypertension was limited. In MIMIC-IV, the association between CTI and all-cause mortality was directionally consistent with that observed in NHANES.Conclusions CTI and 25(OH)D were independently associated with mortality risk in MASLD. Dysglycaemia may represent an important pathway underlying these associations. These markers may aid risk stratification in individuals with MASLD.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Xiaokun Zhang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Luying Zhao"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Shujing Xu"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Shikai Qiao"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Changqing Yang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Jing Li"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Lu Xia"
    }
  ],
  "title": "IDDF2026-ABS-0413 C-reactive protein-triglyceride-glucose index, 25-hydroxyvitamin D, and mortality risk in metabolic dysfunction-associated steatotic liver disease",
  "uid": "36fbf617-8914-5604-8eec-76424e800ec6"
}