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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 met...

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Autores principales: Tang, Ansel Shao Pin, Chan, Kai En, Quek, Jingxuan, Xiao, Jieling, Tay, Phoebe, Teng, Margaret, Lee, Keng Siang, Lin, Snow Yunni, Myint, May Zin, Tan, Benjamin, Sharma, Vijay K, Tan, Darren Jun Hao, Lim, Wen Hui, Kaewdech, Apichat, Huang, Daniel, Chew, Nicholas WS, Siddiqui, Mohammad Shadab, Sanyal, Arun J, Muthiah, Mark, Ng, Cheng Han
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association for the Study of the Liver 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293613/
https://www.ncbi.nlm.nih.gov/pubmed/35232007
http://dx.doi.org/10.3350/cmh.2021.0406
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author Tang, Ansel Shao Pin
Chan, Kai En
Quek, Jingxuan
Xiao, Jieling
Tay, Phoebe
Teng, Margaret
Lee, Keng Siang
Lin, Snow Yunni
Myint, May Zin
Tan, Benjamin
Sharma, Vijay K
Tan, Darren Jun Hao
Lim, Wen Hui
Kaewdech, Apichat
Huang, Daniel
Chew, Nicholas WS
Siddiqui, Mohammad Shadab
Sanyal, Arun J
Muthiah, Mark
Ng, Cheng Han
author_facet Tang, Ansel Shao Pin
Chan, Kai En
Quek, Jingxuan
Xiao, Jieling
Tay, Phoebe
Teng, Margaret
Lee, Keng Siang
Lin, Snow Yunni
Myint, May Zin
Tan, Benjamin
Sharma, Vijay K
Tan, Darren Jun Hao
Lim, Wen Hui
Kaewdech, Apichat
Huang, Daniel
Chew, Nicholas WS
Siddiqui, Mohammad Shadab
Sanyal, Arun J
Muthiah, Mark
Ng, Cheng Han
author_sort Tang, Ansel Shao Pin
collection PubMed
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.
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spelling pubmed-92936132022-07-26 Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals Tang, Ansel Shao Pin Chan, Kai En Quek, Jingxuan Xiao, Jieling Tay, Phoebe Teng, Margaret Lee, Keng Siang Lin, Snow Yunni Myint, May Zin Tan, Benjamin Sharma, Vijay K Tan, Darren Jun Hao Lim, Wen Hui Kaewdech, Apichat Huang, Daniel Chew, Nicholas WS Siddiqui, Mohammad Shadab Sanyal, Arun J Muthiah, Mark Ng, Cheng Han Clin Mol Hepatol Original Article 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. The Korean Association for the Study of the Liver 2022-07 2022-03-02 /pmc/articles/PMC9293613/ /pubmed/35232007 http://dx.doi.org/10.3350/cmh.2021.0406 Text en Copyright © 2022 by The Korean Association for the Study of the Liver https://creativecommons.org/licenses/by-nc/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Tang, Ansel Shao Pin
Chan, Kai En
Quek, Jingxuan
Xiao, Jieling
Tay, Phoebe
Teng, Margaret
Lee, Keng Siang
Lin, Snow Yunni
Myint, May Zin
Tan, Benjamin
Sharma, Vijay K
Tan, Darren Jun Hao
Lim, Wen Hui
Kaewdech, Apichat
Huang, Daniel
Chew, Nicholas WS
Siddiqui, Mohammad Shadab
Sanyal, Arun J
Muthiah, Mark
Ng, Cheng Han
Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293613/
https://www.ncbi.nlm.nih.gov/pubmed/35232007
http://dx.doi.org/10.3350/cmh.2021.0406
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