Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Association of Stroke With Metabolic Dysfunction-Associated Fatty Liver Disease With and Without CKD
First author：Yuhao Li
Corresponding author：Anxin Wang,Yan He
essential_information
- Person in charge：Yuhao Li
- Data Sources： Kailuan Study
- Number of papers：KAILUAN STUDY20230169
- Published time：2023-10-12
2023-10-12
Published articles
Journal：American Journal of Kidney Diseases
Publication type: Original Contributions
IF(IF): 13.2
PMID: 37838141 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
MAFLD was associated with an increased risk of stroke in among individuals with but not in those without CKD.
Main results
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).