Association between nonalcoholic fatty liver disease and stroke: a cross-sectional study

Area of Science:

• Cardiovascular Health
• Hepatology
• Epidemiology

Background:

• Nonalcoholic fatty liver disease (NAFLD) is increasingly recognized as a potential risk factor for cerebrovascular events.
• Existing data on the association between NAFLD and stroke risk in US outpatient settings are limited and inconclusive.
• This study investigates the link between NAFLD and stroke in a large, nationally representative US adult population.

Purpose of the Study:

• To evaluate the association between nonalcoholic fatty liver disease (NAFLD) and the risk of stroke.
• To determine if NAFLD independently predicts stroke incidence in a diverse adult cohort.
• To explore specific demographic subgroups where this association may be more pronounced.

Main Methods:

• Cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) from 1999-2020.
• Nonalcoholic fatty liver disease (NAFLD) diagnosed using the United States Fatty Liver Index (≥30).
• Stroke history self-reported; multivariable logistic regression models adjusted for confounders and survey weights.

Main Results:

• A higher prevalence of stroke was observed in individuals with NAFLD (4.087%) compared to those without (2.215%).
• NAFLD showed an independent association with stroke in unadjusted and demographically adjusted models.
• The association remained significant in specific subgroups, including adults aged 50-65 and those without hypertension, and after inverse probability weighting.

Conclusions:

• Nonalcoholic fatty liver disease (NAFLD) is significantly associated with an increased risk of stroke.
• The findings suggest NAFLD contributes to overall vascular risk, warranting consideration in cardiovascular risk assessments.
• Further longitudinal studies are essential to confirm causality and evaluate the impact of NAFLD treatment on stroke incidence.