ArticleJournal of stroke2020
Liver Enzymes and Risk of Stroke: The Atherosclerosis Risk in Communities (ARIC) Study.
Article in Journal of stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
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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
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Association between risk of ischemic stroke and liver enzymes levels: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Serum liver enzymes and risk of stroke: Systematic review with meta-analyses and Mendelian randomization studies.European journal of neurology · 2024Pooled it
- Associations between Abdominal Aortic Aneurysm with Cardiovascular Disease and All Cause Death in the Atherosclerosis Risk in Communities (ARIC) Study.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 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 educational attainment and discharge disposition following incident stroke hospitalization: the Atherosclerosis Risk in Communities study.Frontiers in stroke · 2026Article
- Interaction effects of dietary carotenoid intake and gamma-glutamyl transferase level on the prevalence of stroke in older adults.Journal of health, population, and nutrition · 2025Observational
- Development and validation of a type 2 diabetes mellitus prediction tool using a large Japanese regional insurance claims database.Scientific reports · 2025Article
- NOX-NOS crosstalk in the liver-brain axis: Novel insights for redox regulation and neurodegenerative diseases.Redox biology · 2025Review
- Associations of Stroke With Risk of Epilepsy: Results From the Atherosclerosis Risk in Communities (ARIC) Study.Annals of clinical and translational neurology · 2025Article
- Association between serum gamma-glutamyltransferase and stroke in adults from national health and nutrition examination survey (2005-2016): a cross-sectional study.BMC cardiovascular disorders · 2025Article
- Association between liver biomarkers and risk of cognitive impairment and dementia: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Association of Liver Fibrosis Markers with Mortality Outcomes in Patients with Chronic Kidney Disease and Coronary Artery Disease: Insights from the NHANES 1999-2018 Data.Cardiorenal medicine · 2025Article
- Association between liver enzyme levels and prevalence of migraine: the atherosclerosis risk in communities study.Therapeutic advances in neurological disorders · 2025Article
- Article
- Development and validation of a machine learning-based predictive model for assessing the 90-day prognostic outcome of patients with spontaneous intracerebral hemorrhage.Journal of translational medicine · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Non-linear association of liver enzymes with cognitive performance in the elderly: A cross-sectional study.PloS one · 2024Article
- Predicting the recurrence of spontaneous intracerebral hemorrhage using a machine learning model.Frontiers in neurology · 2024Article
- Biomarker and genomic analyses reveal molecular signatures of non-cardioembolic ischemic stroke.Signal transduction and targeted therapy · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
background and purposeLiver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma-glutamyl transpeptidase [GGT]) are glutamate-regulatory enzymes, and higher glutamate levels correlated with worse prognosis of patients with neurotrauma. However, less is known about the association between liver enzymes and incidence of stroke. We evaluated the association between serum levels of AST, ALT, and GGT and incidence of stroke in the Atherosclerosis Risk in Communities (ARIC) study cohort from 1990 to 1992 through December 31, 2016.
methodsWe included 12,588 ARIC participants without prevalent stroke and with data on liver enzymes ALT, AST, and GGT at baseline. We used multivariable Cox regression models to examine the associations between liver enzymes levels at baseline and stroke risk (overall, ischemic stroke, and intracerebral hemorrhage [ICH]) through December 31, 2016, adjusting for potential confounders.
resultsDuring a median follow-up time of 24.2 years, we observed 1,012 incident strokes (922ischemic strokes and 90 ICH). In age, sex, and race-center adjusted models, the hazard ratios (HRs; 95% confidence intervals [CIs]) for the highest compared to lowest GGT quartile were 1.94 (95% CI, 1.64 to 2.30) for all incident stroke and 2.01 (95% CI, 1.68 to 2.41) for ischemic stroke, with the results supporting a dose-response association (P for linear trend <0.001). Levels of AST were associated with increased risk of ICH, but the association was significant only when comparing the third quartile with the lowest quartile (adjusted HR, 1.82; 95% CI, 1.06 to 3.13).
conclusionsElevated levels of GGT (within normal levels), independent of liver disease, are associated with higher risk of incident stroke overall and ischemic stroke, but not ICH.
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Registered trials
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.