El-Sayed Omnia Samy, Alnajjar Asmaa Zakria, Arafa Abdelfattah, Mohammed Hazem E, Elettreby Abdelrahman M, Ibraheem Safiya, Tawfik Dalia Esam, Abdullah Menna Allah Ashraf, Tolba Mohamed Ahmed
Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt.
Faculty of Medicine, Al-Azhar University, Gaza, Palestine.
BMC Neurol. 2025 Jan 13;25(1):18. doi: 10.1186/s12883-024-03875-x.
Ischemic stroke is a major public health concern, contributing significantly to global morbidity and mortality. Recent studies have suggested that alterations in liver enzymes may be linked to the risk of developing a stroke. However, the relationship between liver enzymes and ischemic stroke remains unclear.
To examine the potential role of liver enzymes as biomarkers for ischemic stroke.
We systematically searched four databases for articles investigating the association between liver enzymes and ischemic stroke up to March 20th, 2024. Newcastle Ottawa Scale judged the quality of included studies. Risk ratio (RR), hazard ratio (HR), or odds ratio (OR) were extracted and statistically analyzed by RevMan and R software. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessed the certainty of evidence.
Increased levels of gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) have shown statistically significant association with increased ischemic stroke risk (RR: 1.43, 95% CI: [1.30 to 1.57], P > 0.00001) and (RR: 1.60, 95% CI: [1.22 to 2.10], P = 0.0006), respectively. Conversely, increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) showed no significant association with ischemic stroke risk (RR: 0.92, 95% CI: [0.68 to 1.24], P = 0.58) and (RR: 1.43, 95% CI: [0.83 to 2.49], P = 0.20), respectively. The evidence for all outcomes had a low or very low level of certainty.
GGT and ALP could be potential biomarkers for increased ischemic stroke risk, which necessitates careful follow-up. However, AST and ALT did not show such association.
缺血性中风是一个重大的公共卫生问题，对全球发病率和死亡率有重大影响。最近的研究表明，肝酶变化可能与中风发生风险有关。然而，肝酶与缺血性中风之间的关系仍不清楚。
探讨肝酶作为缺血性中风生物标志物的潜在作用。
我们系统检索了四个数据库，以查找截至2024年3月20日研究肝酶与缺血性中风之间关联的文章。采用纽卡斯尔渥太华量表评估纳入研究的质量。提取风险比（RR）、风险率（HR）或比值比（OR），并通过RevMan和R软件进行统计分析。推荐分级、评估、制定与评价（GRADE）评估证据的确定性。
γ-谷氨酰转移酶（GGT）和碱性磷酸酶（ALP）水平升高与缺血性中风风险增加显示出统计学上的显著关联（RR：1.43，95%置信区间：[1.30至1.57]，P＞0.00001）和（RR：1.60，95%置信区间：[1.22至2.10]，P = 0.0006）。相反，丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平升高与缺血性中风风险无显著关联（RR：0.92，95%置信区间：[0.68至1.24]，P = 0.58）和（RR：1.43，95%置信区间：[0.83至2.49]，P = 0.20）。所有结果的证据确定性均为低或极低水平。
GGT和ALP可能是缺血性中风风险增加的潜在生物标志物，需要密切随访。然而，AST和ALT未显示出这种关联。
