Department of Neurology, Tanta University, Tanta, Egypt.
Department of Neurology, Zagazig University, Zagazig, Egypt.
J Clin Lipidol. 2017 Jul-Aug;11(4):915-919. doi: 10.1016/j.jacl.2017.04.115. Epub 2017 May 10.
There is a paucity of data regarding the association between nonalcoholic fatty liver disease (NAFLD) and acute ischemic stroke. Stroke is largely preventable, so that knowledge of risk factors is essential to achieve reductions in the stroke rate and resulting disease burden.
The aim of the present study was to evaluate the prognostic value of NAFLD on stroke severity and outcome.
We prospectively studied 200 patients who were admitted with acute ischemic stroke between September 2013 and August 2015. Demographic and vascular risk factors were detailed for all subjects. The severity of stroke was assessed with National Institutes of Health Stroke Scale score at admission. NAFLD was defined as serum alanine aminotransferase and/or aspartate aminotransferase levels above the upper limit of normal in the absence of other causes of elevated aminotransferase levels. The outcome was assessed with the modified Rankin scale score at discharge.
NAFLD was found in 42.5% of the study population. The prevalence of diabetes was significantly higher among patients with NAFLD than those without NAFLD (P = .001). Waist circumference was significantly higher among patients with NAFLD than those without NAFLD (P < .05). Patients with NAFLD had significantly higher glucose, Triglycerides, Low density lipoprotein, serum alanine aminotransferase and aspartate aminotransferase than those without NAFLD (P < .05 for each comparison). National Institutes of Health Stroke Scale score at admission and modified Rankin scale score at discharge were significantly higher in patients with NAFLD than those without NAFLD (P < .05 for each comparison).
NAFLD was found in 42.5% of acute ischemic stroke patients. NAFLD might be associated with more severe stroke and worse outcome.
非酒精性脂肪性肝病（NAFLD）与急性缺血性脑卒中之间的关联数据较少。脑卒中在很大程度上是可以预防的，因此了解危险因素对于降低脑卒中发病率和疾病负担至关重要。
本研究旨在评估 NAFLD 对脑卒中严重程度和结局的预测价值。
我们前瞻性研究了 200 例 2013 年 9 月至 2015 年 8 月期间因急性缺血性脑卒中入院的患者。所有患者均详细记录了人口统计学和血管危险因素。入院时采用国立卫生研究院脑卒中量表（NIHSS）评分评估脑卒中严重程度。NAFLD 定义为血清丙氨酸氨基转移酶（ALT）和/或天门冬氨酸氨基转移酶（AST）水平高于正常值上限，且无其他原因导致氨基转移酶水平升高。出院时采用改良 Rankin 量表（mRS）评分评估结局。
研究人群中 NAFLD 的患病率为 42.5%。NAFLD 组患者的糖尿病患病率明显高于非 NAFLD 组（P =.001）。NAFLD 组患者的腰围明显高于非 NAFLD 组（P <.05）。与非 NAFLD 组相比，NAFLD 组患者的血糖、三酰甘油、低密度脂蛋白、血清 ALT 和 AST 水平明显更高（每比较均 P <.05）。NAFLD 组患者入院时的 NIHSS 评分和出院时的 mRS 评分均明显高于非 NAFLD 组（每比较均 P <.05）。
42.5%的急性缺血性脑卒中患者存在 NAFLD。NAFLD 可能与更严重的脑卒中及更差的结局相关。
