Abstract
Background/purpose of the studyIf 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.MethodsWe 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.ResultsAmong 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.ConclusionsThe 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.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is emerging as one of the most common chronic liver diseases
Elevated serum palmitic acid (PA) and oleic acid levels are associated with an increased frequency of lacunar stroke, while elevated serum docosahexaenoic acid (DHA) and arachidonic acid (AA) levels are associated with a decreased incidence of ischemic stroke [16]
We evaluated age; sex; ischemic or hemorrhagic stroke; anthropometric variables, such as body weight, body height, and body mass index (BMI); variables of blood pressure such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure; biomarkers, such as serum glucose, HbA1c, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein cholesterol (HDL), triglycerides, AST, ALT, aminotransferase/alanine aminotransferase ratio (AST/ALT) ratio, and GGT; serum concentration of FAs such as saturated fatty acids, lauric acid, myristic acid, PA, and stearic acid; n-9 monounsaturated fatty acids such as oleic acid; n-6 polyunsaturated fatty acids (PUFAs), such as linoleic acid (LiA), dihomo-gamma-linolenic acid (DGLA), and arachidonic acid (AA); n-3 PUFAs such as alpha-linolenic acid (AlA), eicosapentaenoic acid, and docosahexaenoic acid; and FA%
Summary
Non-alcoholic fatty liver disease (NAFLD) is emerging as one of the most common chronic liver diseases. Previous retrospective studies reported that the prevalence of NAFLD defined by increased AST or ALT was 7.7% or 42.5%, respectively, in patients with ischemic stroke [11, 12]; the prevalence of NAFLD diagnosed by US in patients with acute stroke is unknown. Elevated serum dihomo-gamma-linolenic acid (DGLA) level and decreased DHA weight percentage (%) of total fatty acids are associated with the onset of acute ischemic stroke at a younger age [17]. Identifying the factors associated with NAFLD in patients with acute stroke may lead to stroke prevention The purpose of this retrospective cross-sectional study was to investigate whether the frequency of NAFLD diagnosed by US was high and identify the factors associated with NAFLD in patients aged 40–79 years with acute stroke
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