LAUSR

Introduction: Non-alcoholic fatty liver disease (NAFLD) is reported to be a predictor of cardiovascular disease (CD). However, prevalence and associated metabolic factors of NAFLD in stroke middle and young-old-aged patients remain unknown. Hypothesis: In middle and young-old-aged stroke patients, prevalence of NAFLD on admission is high and its metabolic factors are body mass index (BMI), serum Albumin, serum glucose or HbA1c, serum total cholesterol (T-CHO) and triglycerides (TG), some serum fatty acids (FA) and aspartate aminotransferase / alanine aminotransferase ratio (AST/ALT ratio) as well as reported in ischemic heart disease. Methods: We included acute stroke patients who 1) were admitted from August 2016 to December 2018 and aged 40-79 years, 2) underwent abdominal ultrasonography and 3) took blood examination on admission. We evaluated prevalence and associated metabolic factors of NAFLD. Results: Among 1400 acute stroke patients, 660 patients met our inclusive criteria. Their median age was 70.5 years, 264 patients (40.0%) had NAFLD. In NAFLD and non-NAFLD patients, median age was 68 and 72 years (p<0.0001), BMI was 24.6 and 21.6 kg/m 2 (p<0.0001), Alb was 4.2 and 4.0 g/dl (p<0.0001), HbA1c was 6.0 and 5.8 % (p<0.0001), T-CHO was 212 and 200 mg/dl (p<0.001), TG was 134 and 93 mg/dl (p<0.0001), palmitic acid (16:0, saturated FA) was 717 and 619.6 μg/ml (p<0.0001), oleic acid (18:1, n-9 monounsaturated FA) was 659.7 and 552.4 μg/ml (p<0.0001), linoleic acid (18:2, n-6 polyunsaturated FA) was 786.5 and 721.9 μg/ml (p<0.0001) and AST/ALT ratio was 1.07 and 1.36 (p<0.0001), respectively. Stepwise logistic regression analysis by Bayesian information criterion showed that BMI (p<0.0001), TG (p<0.0001) and AST/ALT ratio (p<0.0001) and Alb (p<0.0001) were independent factors of NAFLD. Receiver operating characteristic (ROC) curves for NAFLD showed that cut-off values of BMI, TG, AST/ALT ratio and Alb were 22.3 or more, 108 or more, 1.30 or less and 4.2 or more, respectively. Conclusions: In acute stroke patients aged 40-79 years, prevalence of NAFLD on admission was high and independent metabolic factors of NAFLD were higher BMI, higher TG, lower AST/ALT ratio and higher Alb.