Increased risk of cerebrovascular accident related to non-alcoholic fatty liver disease: a meta-analysis

Jianping Hu, Yong Xu, Zemin He, Hui Zhang, Xiaoqing Lian, Tiantian Zhu, Caihong Liang _ and Jun Li

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Oncotarget. 2018; 9:2752-2760. https://doi.org/10.18632/oncotarget.22755

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Jianping Hu1,*, Yong Xu2,*, Zemin He1,*, Hui Zhang1,*, Xiaoqing Lian3, Tiantian Zhu3, Caihong Liang3 and Jun Li1

1Department of General Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China

2Department of Nephrology, Huai'an Second People's Hospital and The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, China

3Department of Cardiovasology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China

*These authors contributed equally to this work

Correspondence to:

Caihong Liang, email: [email protected]

Jun Li, email: [email protected]

Keywords: cerebrovascular accident; non-alcoholic fatty liver disease; meta-analysis

Received: September 14, 2017     Accepted: October 27, 2017     Published: November 29, 2017


Recent published studies on the association between non-alcoholic fatty liver disease (NAFLD) and cerebrovascular accident (CVA) risk have yielded conflicting findings. The aim of our study was to identify the potential association by pooling all available publications. A total of nine independent studies were included into our study. The pooled odd ratio (OR) with 95% confidence interval (95% CI) was calculated to weigh the strength for the relationship between NAFLD and CVA risk. We also conducted stratified analyses by study design, ethnicity and disease classification for further elucidation. The pooled results of the present meta-analysis showed that NAFLD was related to increased risk of CVA (OR = 2.32, 95% CI 1.84–2.93, P < 0.001). Besides, NAFLD is associated with increased risk of CVA among both Caucasians (OR = 2.27, 95% CI 1.77–2.90, P < 0.001) and Asians (OR = 2.81, 95% CI 1.43–5.51, P = 0.003). Moreover, the significant association was also observed in case-control studies (OR = 2.73, 95% CI 1.67–4.48, P < 0.001) and cohort studies (OR = 2.22, 95% CI 1.71–2.89, P < 0.001), respectively. In addition, NAFLD was shown to correlate with increased risk of cerebral hemorrhage (OR = 1.85, 95% CI 1.05–3.27, P = 0.034) and the ischemic stroke (OR = 2.51, 95% CI 1.92–3.28, P < 0.001). In conclusion, our findings firstly provide strong evidence for a risk effect of NAFLD on CVA development.

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