Non‐alcoholic fatty liver disease and stroke: A Mendelian randomization study

Abstract

Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of progressive liver diseases characterized by ectopic fat accumulation without excessive alcohol consumption [1]. Patients with NAFLD are prone to have a higher risk of cardiovascular diseases by interfered glucose and lipoprotein metabolism, increased oxidative stress, and hypercoagulability [2]. However, reports on the impact of NAFLD on

Mendelian randomization elucidates links between nonalcoholic fatty liver disease and stroke

“…While the Wu et al article [6] enriches our understanding of NAFLD's role in stroke, there are two important caveats. First, whether other forms of chronic liver disease, such as liver fibrosis, cause stroke is not answered.…”

“…to resolve this debate by overcoming confounding, Wu et al[6] performed a Mendelian randomization study of NAFLD and stroke risk, published in this issue of the European Journal of Neurology. In their investigation, Wu et al derived a genetic instrument for NAFLD using genome-wide association study (GWAS) data from a histologically confirmed cohort of individuals with and without NAFLD.…”

“…However, citing inadequate adjustment for confounding in the meta‐analysis, Alexander and colleagues performed a matched cohort study of 18 million European adults, and found a null association between NAFLD and stroke after adjusting for shared risk factors [5]. Aiming to resolve this debate by overcoming confounding, Wu et al [6] performed a Mendelian randomization study of NAFLD and stroke risk, published in this issue of the European Journal of Neurology .…”

Mendelian randomization research investigated the association between nonalcoholic fatty liver disease and the risk of myocardial infarction

“…A cohort study that included 17.7 million participants discovered that NAFLD is unrelated to the risk of MI after controlling for recognized cardiovascular risk factors [6] . However, according to several recent cohort studies, NAFLD was a new independent predictor of MI in people [7,8] .…”

Does nonalcoholic fatty liver disease predispose patients to carotid arteriosclerosis and ischemic stroke?

“…In addition, Baik et al [ 16 ] found that liver fibrosis stage but not steatosis degree, assessed via transient elastography, was an independent predictor of all-cause and cardiovascular mortality during long-term follow-up in patients with ischemic stroke. The potential causal effect of NAFLD on ischemic stroke might be confined to the large artery arteriosclerosis and small vessel occlusion subtypes rather than cardioembolic stroke subtypes, which prompts the heterogeneity of the association [ 17 ]. Moreover, the REGARDS Study declared that advanced liver fibrosis might be associated with a higher risk of ischemic stroke in women, but not in men, suggesting the existence of gender difference [ 18 ].…”