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March 2, 2022Clinical and Molecular HepatologyOpen Access

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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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?

Population

135,602 individuals across multiple studies

Comparison

Patients with NAFLD vs non-NAFLD

Design

Meta-analysis

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.

Authors

ATAnsel Shao Pin TangKCKai En ChanJQJingxuan Quek

Discussion

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Overview

Supports vascular monitoring in NAFLD; hypothesis-generating for outcome-changing trials.

Study Design

Type

Meta-Analysis (n=135,602)

Structured PICO

Does non-alcoholic fatty liver disease increase the risk of carotid atherosclerosis and ischemic stroke?

P
Population
135,602 individuals from 64 studies, including 47,322 patients with non-alcoholic fatty liver disease and 88,280 non-NAFLD controls, evaluated for carotid atherosclerosis and stroke.
E
Exposure
Presence of non-alcoholic fatty liver disease (NAFLD)
C
Comparator
Absence of non-alcoholic fatty liver disease (non-NAFLD)
O
Outcome
Prevalence and risk of carotid atherosclerosis and ischemic strokehard clinical

Main Result

Odds Ratio: 3.2 (95% CI 2.37–4.32)

p-value: p=<0.0001

NAFLD is associated with a significantly increased risk of carotid atherosclerosis and ischemic stroke, suggesting the need for routine carotid assessment in these patients.

Limitations

  • Majority of studies utilized non-invasive, imaging-based investigations rather than biopsy to diagnose NAFLD
  • Grading of NAFLD severity was limited to ultrasonographic findings
  • Unable to assess the effects of stage of fibrosis on CIMT or stroke due to lack of granularity in the reported data
  • Included studies were largely retrospective and subjected to inherent limitations such as selection bias

Cite This Study

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.

synapsesocial.com/papers/6a63dd4eb5b214049b7a73b8https://doi.org/10.3350/cmh.2021.0406
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