What question did this study set out to answer?

This research explores the connection between liver enzyme levels and the risk of hemorrhagic stroke.

May 8, 2026

Abstract Number: Esoc2026a1201 Association Between the Risk of Hemorrhagic Stroke and Liver Enzymes Levels: A Systematic Review and Meta-Analysis of 2,021,882 Patients

Key Points

This research explores the connection between liver enzyme levels and the risk of hemorrhagic stroke.
Systematic search of four databases: PubMed, Scopus, Embase, and Web of Science.
Statistical analysis of Risk Ratio, Hazard Ratio, and Odds Ratio using R Studio software.
A total of 23 studies involving 2,021,882 participants were included in the analysis.
Increased ALP and GGT levels associated with higher hemorrhagic stroke risk (RR = 1.45, 95% CI = 1.01-2.08, p = 0.043) and (RR = 1.36, 95% CI = 1.1-1.69, p = 0.0047).
Higher ALT levels also showed significant association with increased risk (RR = 1.18, 95% CI = 1.06-1.31, p = 0.0032).
AST levels did not show a significant correlation with hemorrhagic stroke risk (RR = 2.23, 95% CI = 0.87-5.76, p = 0.0961).

Abstract

Abstract Background and aims The current literature suggests that liver enzymes are implicated in stroke pathogenethesis. However, conflicting evidence regarding the association of GGT, ALP, ALT, and AST and hemorrhagic stroke risk remains unclear. We aim to explore the association between liver enzymes (GGT, ALP, AST, and ALT) and hemorrhagic stroke risk. Methods We systematically searched four databases (PubMed, Scopus, Embase, and Web of Science) to identify articles investigating the association between liver enzymes and hemorrhagic strokes up to February 2025. Risk Ratio (RR), Hazard Ratio (HR), and Odds Ratio (OR) were statistically analyzed and reported using R Studio software with R (v4.4.2). Results A total of 23 studies were included, 2,021,882 participants. Increased levels of ALP and GGT were significantly associated with an increased risk of hemorrhagic stroke (RR = 1.45, 95% CI = 1.01-2.08, p = 0.043) and (RR = 1.36, 95% CI = 1.1-1.69, p = 0.0047). While AST was not significantly associated with hemorrhagic stroke (RR = 2.23, 95% CI = 0.87-5.76, p = 0.0961), higher levels of ALT demonstrated a significant association with higher risk of hemorrhagic stroke (RR = 1.18, 95% CI = 1.06-1.31, p = 0.0032). mRS 3-6 score and mortality were insignificantly associated with elevated ALP levels, (OR = 1.1, 95% CI = 0.99; 1.22, p = 0.0754) and (OR = 1.49, 95% CI = 0.58; 3.82, p = 0.4105). Conclusions ALT, ALP, and GGT emerged as positive predictors of hemorrhagic stroke risk. while AST exhibited no significant association. These enzymes could serve as potential biomarkers for hemorrhagic stroke. Conflict of interest Omnia Samy El-Sayed: nothing to disclose, Abdelfattah Arafa: nothing to disclose, Ramy Alaser: nothing to disclose, Youssef Nader: nothing to disclose, Ahmed Abo Elnaga: nothing to disclose, Momen Samy Syaj: nothing to disclose, Hind EL Azzazi: nothing to disclose, Mohamed Ahmed Ali: nothing to disclose, Ahmed F Younis: nothing to disclose, Mohamed Ahmed Tolba: nothing to disclose.

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Cite This Study

El-Sayed et al. (Fri,) studied this question.

synapsesocial.com/papers/69fd7ee0bfa21ec5bbf073d4 https://doi.org/https://doi.org/10.1093/esj/aakag023.1509

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