Objective:

To explore the relationship between Vitamin D deficiency, metabolic dysfunction-associated steatotic liver disease (MASLD), and Type 2 Diabetes Mellitus (T2DM) in Sub-Saharan Africa, highlighting how global insights contrast with local contexts and unique challenges.

Key Findings:

• Vitamin D has anti-inflammatory and insulin-sensitizing effects via Vitamin D Receptor (VDR) activation.
• Vitamin D deficiency is associated with increased liver fibrosis and insulin resistance.
• Randomized controlled trials show conflicting results due to variability in dosing and baseline Vitamin D status.
• Unique factors in SSA, such as the 'Vitamin D Paradox' and low prevalence of the PNPLA3 variant, complicate the understanding of Vitamin D's role.

Interpretation:

Vitamin D deficiency may be a modifiable risk factor for MASLD and T2DM in SSA, but existing Eurocentric definitions of deficiency may not be applicable due to unique environmental and genetic factors.

Limitations:

• Limited data specific to African populations regarding Vitamin D, MASLD, and T2DM.
• Heterogeneity in study designs and methodologies across randomized controlled trials, including variations in participant demographics and intervention protocols.

Conclusion:

Future research should establish ancestry-specific Vitamin D reference ranges and conduct region-specific trials to inform public health interventions in SSA, addressing the unique challenges posed by the region's health landscape.