Association between nonalcoholic fatty liver disease with advanced fibrosis and stroke.

TitleAssociation between nonalcoholic fatty liver disease with advanced fibrosis and stroke.
Publication TypeJournal Article
Year of Publication2019
AuthorsParikh NS, VanWagner LB, Elkind MSV, Gutierrez J
JournalJ Neurol Sci
Date Published2019 Dec 15

BACKGROUND: There is an increasing appreciation of the cardiovascular implications of nonalcoholic fatty liver disease with advanced fibrosis (NAFLD-fibrosis). However, data regarding stroke risk are limited. We sought to investigate whether NAFLD-fibrosis is associated with stroke in addition to heart disease.

METHODS: We performed a cross-sectional study using data from the United States National Health and Nutrition Examination Survey (2005-2014). After excluding participants with competing causes of liver disease, the Fibrosis-4 score (FIB-4) and NAFLD Fibrosis Score (NFS) were calculated. First, we used a composite measure to classify participants: NAFLD-fibrosis was defined as having at least one score above its validated cut-off. Second, we also used the FIB-4 and NFS scores individually. The key outcome was prevalent stroke, and we also evaluated heart disease; both were self-reported. Multivariable logistic regression assessed the association between NAFLD-fibrosis and these outcomes while adjusting for demographic variables and cardiovascular risk factors.

RESULTS: We identified 1653 participants with NAFLD-fibrosis from a sample of 27,040 participants. In total, 753 had prior stroke. An association between NAFLD-fibrosis and stroke was seen when using the FIB-4 score (OR 1.87, 95% CI 1.00-3.50) but not the NFS (OR 1.31, 95% CI 0.92-1.87). NAFLD-fibrosis was associated with heart disease (OR 1.46, 95% CI 1.06-2.01) using the composite measure and both scores individually.

CONCLUSIONS: NAFLD-fibrosis may be associated with stroke in addition to heart disease, with differences depending on the measure used to define NAFLD-fibrosis.

Alternate JournalJ. Neurol. Sci.
PubMed ID31644993
PubMed Central IDPMC6891216
Grant ListK23 HL136891 / HL / NHLBI NIH HHS / United States
T32 NS007153 / NS / NINDS NIH HHS / United States

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