The Paradoxical Protective Effect of Liver Steatosis on Severity and Functional Outcome of Ischemic Stroke
The Paradoxical Protective Effect of Liver Steatosis on Severity and Functional Outcome of Ischemic Stroke
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DOI：
10.3389/fneur.2019.00375
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发表时间：
2019-04-12
影响因子：
3.4
通讯作者：
Kim, Young Dae
中科院分区：
文献类型：
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作者：
Baik, Minyoul;Kim, Seung Up;Kim, Young Dae
背景：关于非酒精性脂肪性肝病（NAFLD）与缺血性卒中或短暂性缺血性卒中（TIA）的严重程度或功能结局之间的关系的信息非常有限。我们调查了NAFLD与卒中结局之间的相关性。方法：对321例首次急性缺血性卒中或TIA患者进行NAFLD评估，这些患者于2014年1月至2014年12月进行了短暂弹性成像。采用美国国立卫生研究院卒中量表（NIHSS）评估肝脂肪变性与卒中严重程度的关系，并采用稳健回归分析进行研究。我们还根据肝脂肪变性的存在或负担比较了90天的功能结局。结果：NAFLD 206例（64.2%）。NAFLD患者卒中严重程度较轻（NIHSS评分中位数为2比3，P = 0.012）， 90天功能预后较好（85.3比70.5,P = 0.004）。在多因素分析中，NAFLD患者的NIHSS评分可能降低23.3%[95%可信区间（CI）， -39.2 ~ -3.2%, P = 0.026]，良好功能结局的可能性高出2.5倍（95% CI, 1.08 ~ 5.67, P = 0.033）。结论：我们的研究表明，较高的肝脏脂肪变性负担似乎与缺血性卒中或TIA后较轻的卒中和较好的功能预后相关。
Background: There is very limited information on the relationship between non-alcoholic fatty liver disease (NAFLD) and the severity or functional outcomes of ischemic stroke or transient ischemic stroke (TIA). We investigated the correlation between NAFLD and stroke outcomes.Methods: NAFLD was assessed in 321 patients with first-ever acute ischemic stroke or TIA, who underwent transient elastography from January 2014 to December 2014. The association of liver steatosis with stroke severity, assessed using the National Institute of Health Stroke Scale (NIHSS), was investigated using robust regression analysis. We also compared the functional outcome at 90 days according to the presence or burden of liver steatosis.Results: NAFLD was observed in 206 (64.2%) patients. Patients with NAFLD had less severe stroke (median NIHSS score 2 vs. 3, P = 0.012) and more favorable functional outcome at 90 days (85.3 vs. 70.5, P = 0.004). Patients with NAFLD were likely to have a 23.3% lower [95% confidence interval (CI), -39.2 to -3.2%, P = 0.026] NIHSS score and a 2.5-fold higher (95% CI, 1.08-5.67, P = 0.033) possibility of favorable functional outcome in multivariate analysis.Conclusions: Our study shows that a higher burden of liver steatosis seems to be associated with less severe stroke and better functional outcome after ischemic stroke or TIA.