关键词: 非酒精性脂肪性肝病, 急性脑梗塞, 磁共振, 超声波

Abstract: Objective To explore the relationship between non-alcoholic fatty liver diseases （NAFLD） and acute ischemic stroke and their risk factors. Methods A total of 481 in-hospital patients without alcohol abuse at the Xinhua Hospital affiliated to Shanghai Jiaotong University from January 2013 to November 2013,who had gone through both cranial magnetic resonance image （MRI） plus diffusion weighted imaging （DWI） and abdominal ultrasonography,were enrolled. Among them,225 patients had NAFLD and 218 were diagnosed with acute ischemic stroke. Correlation analysis of the association between NAFLD and acute ischemic stroke was carried out by studying fasting plasma biochemical indexes,results of carotid vascular ultrasonography and American National Institutes of Health Stroke Scale （NIHSS） scores. Results In our study,the mean age of NAFLD patients with or without acute ischemic stroke were（68.49±10.88） yr and （62.83±11.68） yr,respectively. There existed statistic difference between the two groups in 24-hour average systolic pressure[（152.11±14.69） mmHg vs.（139.76±20.19） mmHg],ALT[（23.69±14.8） U/L vs. （29.34±17.89） U/L],HbA1c[（7.03±1.86） vs.（6.33±1.35）%],fasting blood glucose levels[（7.14±2.61） vs. （6.15±1.89） mmol/L] and 2 h postprandial blood glucose [（11.33±4.45） vs. （9.66±4.23） mmol/L],P<0.05 for all. Binomial Logistic multivariate regression analysis identified 24-hour average systolic pressure （OR 1.028,95%CI 1.005-1.052）,age（OR 1.054,95%CI 1.013-1.097）,and fasting blood glucose（OR 1.338,95%CI 1.039-1.723） were independently associated with the occurrence of acute ischemic stroke in NAFLD patients. Differences existed between acute ischemic stroke patients with or without NAFLD in serum levels of GGT [（34.75±30.98） U/L vs. （26.21±16.62）U/L],total cholesterol [（12.26±7.72） mmol/L vs.（4.43±1.03） mmol/L],triglycerides[（1.82±0.92） mmol/L vs. （1.26±0.6）mmol/L],LDL-C[（2.97±0.79） mmol/L vs.（2.73±0.71） mmol/L],HbA1c[（7.03±1.86） vs.（6.32±1.34）%],fasting blood glucose[（7.14±2.61） mmol/L vs.（6.38±2.13） mmol/L] and 2 h postprandial blood glucose[（11.33±4.45） mmol/L vs.（9.66±4.23） mmol/L],P<0.05 for all. Binomial Logistic multivariate regression analysis revealed HbA1c（OR 1.468,95%CI 1.057-2.04） and triglycerides（OR 2.479,95%CI 1.375-4.468） were independent risk factors for the occurrence of NAFLD in acute ischemic stroke patients. Conclusion This study suggests that advanced age,elevated systolic pressure and fasting blood glucose are risk factors for NAFLD patients developing acute ischemic stroke,and hypertriglyceridemia and hyperglycemia are risk factors for acute ischemic stroke patients with underlying NAFLD.

Key words: Non-alcoholic fatty liver diseases, Acute ischemic stroke, Magnetic resonance image, Ultrasound