Non-alcoholic fatty liver disease frequency and associated factors at admission of acute stroke

Hepatol Int. 2022 Feb;16(1):81-88. doi: 10.1007/s12072-021-10253-z. Epub 2021 Sep 15.

Abstract

Background/purpose of the study: If non-alcoholic fatty liver disease (NAFLD) frequency is very high in stroke patients, NAFLD may be a risk factor for stroke and identifying factors of NAFLD presence may lead to stroke prevention. This retrospective study aimed to investigate whether NAFLD frequency was very high and identify factors associated with NAFLD presence at acute stroke admission.

Methods: We included stroke patients aged 40 - 79 years who (1) were admitted from 2016 to 2019, within 24 h of onset; (2) underwent abdominal ultrasonography; and (3) underwent blood examination of biomarkers. We evaluated the frequency and significant factors of NAFLD presence.

Results: Among 1672 stroke patients, 676 patients met our inclusion criteria, and 267 patients (39.5%) had NAFLD. Compared to patients without NAFLD, patients with NAFLD were young; had high anthropometric values; high blood pressure; low aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT) ratio; high levels of liver enzymes, serum albumin, HbA1c, and serum lipids; low-density lipoprotein; high serum level of some fatty acids; and high fatty acid% of palmitic acid (PA) and dihomo-gamma-linolenic acid (DGLA). After excluding variables with multicollinearity, independent NAFLD-presence factors were high body mass index (BMI), low AST/ALT ratio, high serum albumin level, high PA%, and high DGLA level.

Conclusions: The frequency of NAFLD was high in our patient group. Significant NAFLD-presence factors were high BMI, low AST/ALT ratio, high serum albumin level, high PA%, and high DGLA level. A further study is warranted to determine the effects of the NAFLD-presence factors on stroke onset or prevention.

Keywords: AST/ALT ratio; Albumin; BMI; Blood pressure; DGLA; HbA1c; Hemorrhagic stroke; Ischemic stroke; Palmitic acid; Predictor.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase
  • Aspartate Aminotransferases
  • Humans
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / diagnostic imaging
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Stroke* / epidemiology
  • Stroke* / etiology

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase