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Association between nonalcoholic fatty liver disease and stroke: a cross-sectional study Shuai Zhou, Ge Mang, Hu Zhou, Shuoqi Zhang, Adam A. Dmytriw, Baocheng Gao, Shengquan Huang, Shuaifeng Yang, Lide Jin, Yongfa Zhang, Jiaqi Jin, Tianhua Li International Journal of Surgery.2026; 112(5): 11170. CrossRef
No association between steatotic liver disease and atherosclerosis among Brazilian
travestis
and transgender women: a cross-sectional study
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Correspondence on Editorial regarding “Screening and prediction of nonalcoholic fatty liver disease using a peripheral insulin resistance index: Potential benefits and limitations” Jun-Hyuk Lee, Kyongmin Park, Hye Sun Lee, Hoon-Ki Park, Jee Hye Han, Sang Bong Ahn Clinical and Molecular Hepatology.2023; 29(1): 185. CrossRef
Impact of metabolic risk factors on hepatic and cardiac outcomes in patients with alcohol- and non-alcohol-related fatty liver disease Jihye Lim, Hyunji Sang, Ha Il Kim JHEP Reports.2023; 5(6): 100721. CrossRef
Ansel Shao Pin Tang, Kai En Chan, Jingxuan Quek, Jieling Xiao, Phoebe Tay, Margaret Teng, Keng Siang Lee, Snow Yunni Lin, May Zin Myint, Benjamin Tan, Vijay K Sharma, Darren Jun Hao Tan, Wen Hui Lim, Apichat Kaewdech, Daniel Huang, Nicholas WS Chew, Mohammad Shadab Siddiqui, Arun J Sanyal, Mark Muthiah, Cheng Han Ng
Clin Mol Hepatol 2022;28(3):483-496. Published online March 2, 2022
Background/Aims Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD.
Methods Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD.
Results From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD.
Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.
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Background/Aims We aimed to investigate the silent atherosclerotic burden of cervicocephalic vessels in cirrhotic patients compared with the general population, as well as the relevant risk factors including coronary parameters.
Methods This study included 993 stroke-free patients with liver cirrhosis (LC) who underwent magnetic resonance angiography (MRA) of the head and neck as a pre-liver transplant assessment and 6,099 health checkup participants who underwent MRA examination. The two cohorts were matched for cerebrovascular risk factors, and the prevalence of atherosclerosis in major intracranial and extracranial arteries was compared in 755 matched pairs. Moreover, traditional, hepatic, and coronary variables related to cerebral atherosclerosis were assessed in cirrhotic patients.
Results Overall, intracranial atherosclerosis was significantly less prevalent in the LC group than in the matched control group (2.3% vs. 5.4%, P=0.002), whereas the prevalence of extracranial atherosclerosis was similar (4.4% vs. 5.8%, P=0.242). These results were maintained in multivariate analyses of the pooled samples, with corresponding adjusted odds ratios [ORs] of LC of 0.56 and 0.77 (95% confidence intervals [CIs], 0.36–0.88 and 0.55–1.09). In the LC group, lower platelet count was inversely correlated with intracranial atherosclerosis (adjusted OR, 0.31; 95% CI, 0.13–0.76). Coronary artery calcium (CAC) score ≥100 was the only predictive factor for both intracranial and extracranial atherosclerosis (adjusted ORs, 4.06 and 5.43, respectively).
Conclusions LC confers protection against intracranial atherosclerosis, and thrombocytopenia may be involved in this protective effect. High CAC score could serve as a potential surrogate for cervicocerebral vascular screening in asymptomatic cirrhotic patients.
Citations
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Letter: cervicocerebral atherosclerosis and its hepatic and coronary risk factors in patients with liver cirrhosis Yi-Chun Huang, Chih-Wei Chen, James Chun-Chung Wei Clinical and Molecular Hepatology.2022; 28(2): 265. CrossRef
Reply: Letter: cervicocerebral atherosclerosis and its hepatic and coronary risk factors in patients with liver cirrhosis Jihyun An, Ju Hyun Shim Clinical and Molecular Hepatology.2022; 28(2): 267. CrossRef
Su-Yeon Choi, M.D., Donghee Kim, M.D., Jin Hwa Kang, M.D.1, Min Jung Park, M.D.,
Young Sun Kim, M.D., Seon Hee Lim, M.D., Chung Hyeon Kim, M.D., Hyo-Suk Lee, M.D.2
Korean J Hepatol 2008;14(1):77-88. Published online March 20, 2008
Background/Aims Non-alcoholic fatty liver disease (NAFLD) is closely associated with abdominal obesity, dyslipidemia, hypertension, and Type 2 diabetes, which are all features of the metabolic syndrome. The aim of the present study was to elucidate whether NAFLD is associated with carotid atherosclerosis. Methods: The study population comprised 659 subjects without hepatitis B and C infections and who did not consume alcohol. Fatty infiltrations of liver were detected by abdominal ultrasonography, and intima-media thickness (IMT) and plaque prevalence were estimated by carotid ultrasonography. Results: The mean values of systolic and diastolic pressures, body mass index (BMI), aspartate aminotransferase, alanine aminotransferase, gamma- glutamyl transpeptidase, uric acid, total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, fasting glucose, fasting insulin, homeostasis model of assessment (HOMA) index, hemoglobin A1c, and plasminogen activator inhibitor-1 differed significantly between patients with NAFLD (n=314) and normal controls (n=345). The carotid IMT was 0.817±0.212 (mean±SD) mm in patients with NAFLD and 0.757±0.198 mm in normal controls (p<0.001). The prevalence of carotid plaques was higher in patients with NAFLD (26.4%) than in normal controls (15.9%) (p<0.001). This association persisted significantly after adjusting for age, sex, BMI, HOMA index and individual factors of metabolic syndrome by multiple logistic regression analysis. Conclusions: Patients with NAFLD are at a high risk of carotid atherosclerosis regardless of metabolic syndrome and classical cardiovascular risk factors. Therefore, the detection of NAFLD should alert to the existence of an increased cardiovascular risk. Moreover, NAFLD might be an independent risk factor for cardiovascular disease. (Korean J Hepatol 2008;14:77-88)
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