Liver Disease and Ischemic Stroke Correlation

Liver disease and ischaemic stroke are increasingly recognised as interlinked conditions driven by shared metabolic, inflammatory and haemostatic disturbances. Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of metabolic syndrome, has been associated with endothelial dysfunction, prothrombotic states and systemic inflammation, all of which contribute to cerebrovascular risk. Progressive liver fibrosis and cirrhosis further exacerbate coagulopathy and vascular instability, influencing stroke severity and outcomes. Epidemiological studies reveal that patients with NAFLD exhibit a higher incidence of first-ever and recurrent ischaemic stroke, while those with advanced fibrosis or cirrhosis face greater in-hospital mortality and neurological complications. Mechanistic work implicates adipokine dysregulation, oxidative stress and gut–liver–brain axis perturbations as mediators of cerebrovascular injury. Recognition of liver disease as an independent risk factor has prompted research into integrated screening, risk stratification tools employing non-invasive fibrosis scores, and multidisciplinary management strategies to mitigate global stroke burden.

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Liver Disease and Ischemic Stroke Correlation publication trend

The graph below shows the total number of articles in liver disease and ischemic stroke correlation across all publications each year (not limited to Nature Index journals).

Technical terms

Non-alcoholic fatty liver disease (NAFLD): hepatic lipid accumulation in the absence of significant alcohol intake, linked to metabolic syndrome.

Liver fibrosis: progressive scarring of the liver parenchyma resulting from chronic injury, graded by non-invasive indices or histology.

Cirrhosis: advanced liver fibrosis with architectural distortion, portal hypertension and impaired hepatic function.

Fibrosis-4 (FIB-4) index: a laboratory-derived score incorporating age, aminotransferases and platelet count to estimate liver fibrosis stage.

Ischaemic stroke: sudden neurological deficit due to cerebral artery occlusion and subsequent brain tissue infarction.

References

1. Nonalcoholic fatty liver disease is an independent risk factor for ischemic stroke after revascularization in patients with Moyamoya disease: a prospective cohort study. Lipids in Health and Disease (2024).
2. Cirrhosis Is an Independent Risk Factor for Mortality in Ischemic Stroke—A Nationwide Analysis. International Journal of Hepatology (2025).
3. Association Between Non-alcoholic Fatty Liver Disease and Risk of Stroke: A Systematic Review and Meta-Analysis. Frontiers in Cardiovascular Medicine (2022).