Trial reportPloS one2018
Non-alcoholic fatty liver disease, liver biomarkers and stroke risk: The Reasons for Geographic and Racial Differences in Stroke cohort.
Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Association between risk of ischemic stroke and liver enzymes levels: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Association Between Non-alcoholic Fatty Liver Disease and Risk of Stroke: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Nonalcoholic fatty liver disease as a metabolic disease in humans: A literature review.Diabetes, obesity & metabolism · 2021Pooled it
- The association between liver disease and stroke risk: A cross-sectional study with machine learning in a large-scale Chinese cohort.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Perioperative Liver Function Parameters as Potential Predictors o f Hemorrhagic Transformation in Acute Ischemic Stroke Patients with Successful Recanalization after Endovascular Treatment: A Retrospective Cohort Study.Current neurovascular research · 2026Article
- Association between ALBI score and stroke risk and all-cause mortality: 2011 to 2018 NHANES.Medicine · 2025Article
- Circulating biomarkers and ischemic stroke risk in adults with atrial fibrillation taking anticoagulation: the Reasons for Geographic And Racial Differences in Stroke study.Journal of thrombosis and haemostasis : JTH · 2025Article
- Improving stroke risk prediction in atrial fibrillation with circulating biomarkers: the CHAJournal of thrombosis and haemostasis : JTH · 2025Article
- A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches.Journal of clinical medicine · 2024Review
- The fatty liver index and risk of incident venous thromboembolism: the Tromsø Study.Research and practice in thrombosis and haemostasis · 2024Article
- Aspartate aminotransferase/alanine aminotransferase ratio was associated with type 2 diabetic peripheral neuropathy in a Chinese population: A cross-sectional study.Frontiers in endocrinology · 2023Article
- Nonalcoholic fatty liver disease and cognitive impairment: A prospective cohort study.PloS one · 2023Article
- Avenues within the gut-liver-brain axis linking chronic liver disease and symptoms.Frontiers in neuroscience · 2023Review
- Linking Nonalcoholic Fatty Liver Disease and Brain Disease: Focusing on Bile Acid Signaling.International journal of molecular sciences · 2022Review
- Association between liver fibrosis and incident dementia in the UK Biobank study.European journal of neurology · 2022Article
- Biomarkers as MEDiators of racial disparities in risk factors (BioMedioR): Rationale, study design, and statistical considerations.Annals of epidemiology · 2022Article
- Liver biomarkers, genetic and lifestyle risk factors in relation to risk of cardiovascular disease in Chinese.Frontiers in cardiovascular medicine · 2022Article
- Article
- Liver Fibrosis is Associated with Ischemic Stroke Risk in Women but not Men: The REGARDS Study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021Article
- The Association between Nonalcoholic Fatty Liver Disease and Stroke: Results from the Korean Genome and Epidemiology Study (KoGES).International journal of environmental research and public health · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
background and purposeLiver disease, particularly non-alcoholic fatty liver disease (NAFLD), is a risk factor for cardiovascular disease, but little is known about its relationship with ischemic stroke.
methodsIn the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort of 30,239 American black and white adults, we assessed baseline NAFLD as fatty liver index (FLI) >60, and assessed liver biomarkers aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and the AST/ALT ratio and risk of incident ischemic stroke over 5.8 years using a case-cohort study design.
resultsConsidering 572 strokes and a 1,017-person cohort sample, NAFLD was inversely associated with stroke risk in men (HR: 0.50; 95% CI: 0.26, 0.96), as was being in the highest ALT quintile versus the lowest (HR: 0.39; 95% CI: 0.19, 0.78) and the highest versus lowest GGT quintile (HR: 0.45, 95% CI: 0.24, 0.85), but not in women. Conversely, FLI score above the 90th percentile was associated with increased stroke risk among women (HR: 2.26; 95% CI: 1.14-4.47), but not men. AST was not associated with stroke risk in either sex. AST/ALT ratio >2 was strongly associated with increased stroke risk in whites, but not blacks (HRs: 3.64; 95% CI: 1.42-9.35 and 0.97; 95% CI: 0.45-1.99, respectively; p for interaction = 0.03).
conclusionsThe relationships between NAFLD, liver biomarkers, and ischemic stroke are complex, and sex and race differences we observed require further study and confirmation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.