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Liver fibrosis assessed with transient elastography is an independent risk factor for ischemic stroke

 Seung Up Kim  ;  Dongbeom Song  ;  Ji Hoe Heo  ;  Joonsang Yoo  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang Joon Kim  ;  Kwang-Hyub Han  ;  Young Dae Kim 
 Atherosclerosis, Vol.260 : 156-162, 2017 
Journal Title
Issue Date
Acute Disease ; Biopsy ; Body Mass Index ; Brain/diagnostic imaging ; Brain Ischemia/diagnosis ; Brain Ischemia/epidemiology ; Brain Ischemia/etiology* ; Elasticity Imaging Techniques/methods* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Liver/diagnostic imaging* ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnostic imaging* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Odds Ratio ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment* ; Risk Factors ; Tomography, X-Ray Computed
Liver stiffness ; Risk factors ; Stroke ; Transient elastography
BACKGROUND AND AIMS: The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. METHODS: Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses. RESULTS: Two hundred ninety-five patients with ischemic stroke (stroke group) and 1942 subjects with health check-up (control group) were included. The mean liver stiffness (LS) on TE (5.6 vs. 4.1 kPa) and the proportion of significant fibrosis (>8 kPa) (9.2% vs. 1.8%) were significantly higher in the stroke than in the control group (all p<0.05). These trends were observed regardless of body mass index, the degree of hepatic steatosis, and metabolic syndrome (all p<0.05). The adjusted odds ratio (OR) for ischemic stroke was 1.268 (95% confidence intervals [CI] 1.183-1.358) per 1 kPa increase and 12.033 (95% CI 5.180-27.948) for significant fibrosis, compared with no fibrosis (all p < 0.05). Propensity-score matched analysis also confirmed that liver fibrosis was independently associated with the risk of ischemic stroke (OR 1.804 [95% CI 1.461-2.230] per 1 kPa increase, 13.184 [95% CI 3.127-55.645] for significant fibrosis, compared with no fibrosis; all p<0.001). CONCLUSIONS: The degree of liver fibrosis, assessed with TE, was significantly associated with the risk of ischemic stroke.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
김광준(Kim, Kwang Joon) ORCID logo https://orcid.org/0000-0002-5554-8255
김도영(Kim, Do Young)
김범경(Kim, Beom Kyung) ORCID logo https://orcid.org/0000-0002-5363-2496
김승업(Kim, Seung Up) ORCID logo https://orcid.org/0000-0002-9658-8050
김영대(Kim, Young Dae) ORCID logo https://orcid.org/0000-0001-5750-2616
박준용(Park, Jun Yong) ORCID logo https://orcid.org/0000-0001-6324-2224
송동범(Song, Dong Beom)
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
유준상(Yoo, Joon Sang)
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
허지회(Heo, Ji Hoe) ORCID logo https://orcid.org/0000-0001-9898-3321
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