Associations between nonalcoholic fatty liver disease and ischemic stroke

Table 1 Major studies that evaluated the association between nonalcoholic fatty liver disease and ischemic stroke

Ref.	Design	Mean age (yr)	Follow-up	Outcome
[7]	Prospective observational study in 1637 healthy Japanese men/women	47.8	2 yr	Higher incidence of CVD including stroke in patients with NAFLD compared with controls
[22]	Prospective study in 242 patients admitted with acute stroke	66	2 yr	Increased risk of acute stroke, more severe stroke and worse outcome in patients with NAFLD
[11]	Prospective study in 6997 men with no history of CVD or diabetes mellitus	40-59	24 yr	Association between gGT and higher incidence of fatal, major stroke events and total CVD mortality
[10]	Cross sectional study in adults with suspected acute stroke	20-27	Not applicable	Elevated ALP and ALT levels independently associated with higher risk of acute stroke
[12]	Case-control study using data from 3 European cohort studies in 13177 subjects	40-60	3-8 yr	Elevated gGT levels associated with higher risk of stroke
[21]	Case-control study in 295 patients with acute stroke and 1942 healthy subjects	60	Not applicable	Liver fibrosis was associated with higher incidence of ischemic stroke
[20]	Meta analysis of 9 studies that examined relation of NAFLD and stroke	Not reported	Not applicable	Higher risk of ischemic stroke and hemorrhagic stroke in patients with NAFLD
[23]	Retrospective study in 306 patients with confirmed brainstem infractions	65	Not applicable	Higher incidence of brainstem infracts in patients with NAFLD
[24]	Study in 415 patients admitted with acute ischemic stroke	78.8	Duration of hospitalization	NAFLD was not associated with stroke severity at admission or outcome during hospitalization
[19]	Case-cohort study in 572 patients with stroke and 1017 controls	> 45	5.8 yr	Fatty liver index associated with increased risk for ischemic stroke in women and with lower risk in women
[20]	Cross-sectional study in 1277 subjects who underwent brain magnetic resonance imaging and abdominal ultrasound during check-up	> 40 yr	Not applicable	NAFLD diagnosed with ultrasonography was associated with increased prevalence of lacunar infarcts in non-obese subjects but not in obese patients

CVD: Cardiovascular disease; gGT: G-glutamyltransferase; ALP: Alkaline phosphatase; ALT; Alanine aminotransferase; NAFLD: Nonalcoholic fatty liver disease.