Key result
Non-alcoholic fatty liver disease was associated with a significantly increased risk of carotid atherosclerosis (OR 3.20) and stroke (OR 1.88) compared to non-NAFLD controls.
Why the study?
While studies had examined cardiac remodeling in NAFLD, there had been less emphasis on the development of carotid atherosclerosis and stroke.
Does non-alcoholic fatty liver disease increase the risk of carotid atherosclerosis and ischemic stroke?
Meta-Analysis (n=135,602)
Does non-alcoholic fatty liver disease increase the risk of carotid atherosclerosis and ischemic stroke?
Answers are grounded in this paper and cite their sources.
NAFLD is associated with a significantly increased risk of carotid atherosclerosis and ischemic stroke, suggesting the need for routine carotid assessment in these patients.
BACKGROUND/AIMS: Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. METHODS: Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. RESULTS: From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36-43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37-4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74-9.09%) with an odds ratio of 1.88 (95% CI, 1.23-2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. CONCLUSION: This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.
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Tang et al. (2022) conducted a meta-analysis in Non-alcoholic fatty liver disease (NAFLD) (n=135,602). Non-alcoholic fatty liver disease (NAFLD) vs. Non-NAFLD controls was evaluated on Carotid atherosclerosis (OR 3.20, 95% CI 2.37-4.32, p=<0.0001). Non-alcoholic fatty liver disease was associated with a significantly increased risk of carotid atherosclerosis (OR 3.20) and stroke (OR 1.88) compared to non-NAFLD controls.
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