国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

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Association of Stroke With Metabolic Dysfunction-Associated Fatty Liver Disease With and Without CKD

第一作者：Yuhao Li

通讯作者：Anxin Wang,Yan He

All-cause mortality; Chronic kidney disease; Hepatic steatosis; Metabolic dysfunction-associated fatty liver disease; Stroke.

基本信息

  • 负责人：Yuhao Li
  • 数据来源： Kailuan Study
  • 论文编号：KAILUAN STUDY20230169
  • 发表时间：2023-10-12

2023-10-12

已发表文章

发表杂志：American Journal of Kidney Diseases

发表类型: Original Contributions

影响因子(IF): 13.2

PMID: 37838141 Pubmed原文链接 全文下载

主要研究背景及目的

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a risk factor for stroke and all-cause mortality and highly prevalent among patients with chronic kidney disease (CKD). It is unclear whether the association of MAFLD with stroke and all-cause mortality differs within and outside of the setting of CKD.

方法

Study design: Prospective cohort study. Setting: & Participants: We enrolled 95,353 participants from the Kailuan Cohort Study, among whom 35,749 had CKD at baseline or developed CKD during follow-up, and 59,604 had no CKD at baseline or during follow-up. Exposure: MAFLD. Outcomes: Stroke (ischemic stroke, hemorrhagic stroke), all-cause mortality. Analytical approach: Adjusted Cox regression models were used to estimate the influence of MAFLD on stroke outcomes within the subgroups defined by the presence of CKD.

结论

MAFLD was associated with an increased risk of stroke in among individuals with but not in those without CKD.

主要结果

After a median follow-up of 12.8 years, 6,140 (6.4%) strokes and 11,975 (12.6%) deaths from any cause occurred. After adjusting for potential confounders, MAFLD was associated with an increased incidence of stroke among participants with CKD (HR: 1.34, 95%CI: 1.23-1.45), but not among those without CKD (HR: 1.05, 95%CI: 0.97-1.15) (P-interaction<0.001). This association was principally related to ischemic stroke (HR: 1.38, 95%CI: 1.26-1.51) and not hemorrhagic stroke (HR: 1.04, 95%CI: 0.85-1.26). No association was found between MAFLD and all-cause mortality in participants with (HR:1.04, 95%CI: 0.98-1.10) or without CKD (HR:1.03, 95%CI: 0.97-1.09). Among participants with CKD, compared with non-MAFLD, MAFLD with diabetes (HR:1.36, 95%CI: 1.23-1.50) or overweight/obesity (HR:1.30, 95%CI: 1.14-1.50) was associated with a higher risk of stroke, while MAFLD without overweight/obesity or diabetes was not associated with a higher risk (HR:1.08, 95%CI: 0.81-1.43).