Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals
Background/Aims Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta...
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| Format: | Article |
| Language: | English |
| Published: |
Korean Association for the Study of the Liver
2022-07-01
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| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2021-0406.pdf |
| _version_ | 1818097186246754304 |
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| author | Ansel Shao Pin Tang Kai En Chan Jingxuan Quek Jieling Xiao Phoebe Tay Margaret Teng Keng Siang Lee Snow Yunni Lin May Zin Myint Benjamin Tan Vijay K Sharma Darren Jun Hao Tan Wen Hui Lim Apichat Kaewdech Daniel Huang Nicholas WS Chew Mohammad Shadab Siddiqui Arun J Sanyal Mark Muthiah Cheng Han Ng |
| author_facet | Ansel Shao Pin Tang Kai En Chan Jingxuan Quek Jieling Xiao Phoebe Tay Margaret Teng Keng Siang Lee Snow Yunni Lin May Zin Myint Benjamin Tan Vijay K Sharma Darren Jun Hao Tan Wen Hui Lim Apichat Kaewdech Daniel Huang Nicholas WS Chew Mohammad Shadab Siddiqui Arun J Sanyal Mark Muthiah Cheng Han Ng |
| author_sort | Ansel Shao Pin Tang |
| collection | DOAJ |
| description | Background/Aims Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. Methods Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. Results From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD. |
| first_indexed | 2024-12-10T23:16:31Z |
| format | Article |
| id | doaj.art-6b6d5630aac840db9fc0557d9bb72d6f |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-10T23:16:31Z |
| publishDate | 2022-07-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-6b6d5630aac840db9fc0557d9bb72d6f2022-12-22T01:29:49ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2022-07-0128348349610.3350/cmh.2021.04061667Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individualsAnsel Shao Pin Tang0Kai En Chan1Jingxuan Quek2Jieling Xiao3Phoebe Tay4Margaret Teng5Keng Siang Lee6Snow Yunni Lin7May Zin Myint8Benjamin Tan9Vijay K Sharma10Darren Jun Hao Tan11Wen Hui Lim12Apichat Kaewdech13Daniel Huang14Nicholas WS Chew15Mohammad Shadab Siddiqui16Arun J Sanyal17Mark Muthiah18Cheng Han Ng19 Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore Bristol Medical School, University of Bristol, Bristol, UK Yong Loo Lin School of Medicine, National University of Singapore, Singapore Division of Neurology, Department of Medicine, National University Hospital, Singapore Division of Neurology, Department of Medicine, National University Hospital, Singapore Division of Neurology, Department of Medicine, National University Hospital, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore Yong Loo Lin School of Medicine, National University of Singapore, SingaporeBackground/Aims Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. Methods Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. Results From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.http://e-cmh.org/upload/pdf/cmh-2021-0406.pdfatherosclerosisstrokeischemic strokenonalcoholic fatty liver disease |
| spellingShingle | Ansel Shao Pin Tang Kai En Chan Jingxuan Quek Jieling Xiao Phoebe Tay Margaret Teng Keng Siang Lee Snow Yunni Lin May Zin Myint Benjamin Tan Vijay K Sharma Darren Jun Hao Tan Wen Hui Lim Apichat Kaewdech Daniel Huang Nicholas WS Chew Mohammad Shadab Siddiqui Arun J Sanyal Mark Muthiah Cheng Han Ng Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals Clinical and Molecular Hepatology atherosclerosis stroke ischemic stroke nonalcoholic fatty liver disease |
| title | Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals |
| title_full | Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals |
| title_fullStr | Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals |
| title_full_unstemmed | Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals |
| title_short | Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals |
| title_sort | non alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke an updated meta analysis with 135 602 individuals |
| topic | atherosclerosis stroke ischemic stroke nonalcoholic fatty liver disease |
| url | http://e-cmh.org/upload/pdf/cmh-2021-0406.pdf |
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