Key result
Advanced liver fibrosis is linked to ~88% higher risk of post-stroke depression at 3 months.
Why the study?
Liver fibrosis has been considered a predictor of cardiovascular disease, but its relationship with post-stroke depression at 3 months was unclear.
Cohort (n=326)
Blinded outcome assessment
No
May aid post-stroke depression risk stratification; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND AND OBJECTIVE: Liver fibrosis has been considered a predictor of cardiovascular disease. This study aimed to evaluate whether the degree of liver fibrosis is related to post-stroke depression (PSD) at 3 months follow-up. METHODS: We prospectively and continuously enrolled patients with first-ever ischemic stroke from June 2020 to January 2022. Liver fibrosis was measured after admission by calculating the Fibrosis-4 index (FIB-4) and stratified into two categories (< 2.67 versus ≥ 2.67). Patients with a 17-item Hamilton Depression Scale score > 7 were further evaluated using the Chinese version of the structured clinical interview of DSM-IV, for diagnosing PSD at 3 months. RESULTS: A total of 326 patients (mean age 66.6 years, 51.5% male) were recruited for the study. As determined by the FIB-4 score, 80 (24.5%) patients had advanced liver fibrosis. During the follow-up, PSD was observed in 91 patients, which accounted for 27.9% (95% confidence interval [CI] 25.5%-30.5%) of the cohort. The prevalence of advanced liver fibrosis was higher in PSD patients than those without PSD (40.0% versus 24.0%; P = 0.006). After adjustment for covariates in the multivariate logistic analysis, advanced fibrosis was significantly associated with PSD (odds ratio [OR], 1.88; 95% CI, 1.03-3.42; P = 0.040). Similar results were found when the FIB-4 was analyzed as a continuous variable. CONCLUSIONS: This study found that advanced liver fibrosis was associated with an increased risk of 3-month PSD. FIB-4 score may be valuable for screening depressive symptoms in ischemic stroke patients.
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Zhang et al. (2023) conducted a cohort in Ischemic stroke (n=326). Advanced liver fibrosis vs. Without advanced liver fibrosis was evaluated on Post-stroke depression (PSD) at 3 months (OR 1.88, 95% CI 1.03-3.42, p=0.040). Advanced liver fibrosis in patients with acute ischemic stroke was independently associated with an increased risk of post-stroke depression at 3 months (OR 1.88).
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