Vitamin D and the metabolic-associated steatotic liver disease—type 2 diabetes axis: a scoping-narrative review of global evidence and emerging perspectives for Sub-Saharan Africa

Vitamin D deficiency is a plausible, modifiable driver of the MASLD-T2DM axis in Sub-Saharan Africa, potentially filling the risk void left by the absence of major genetic drivers like <i>PNPLA3</i>. However, Eurocentric thresholds for deficiency may not apply. Future research must prioritize establishing ancestry-specific reference ranges and conducting region-specific trials that account for the "triple burden" of HIV, urbanization, and dietary transition to inform effective public health interventions such as fortification.