Fatty liver and cerebrovascular disease: plausible association and possible mechanisms

Sahil Khanna, Neal S. Parikh, Lisa B. VanWagner*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Purpose of review Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity and has wide ranging extrahepatic manifestations, including through cardiometabolic pathways. As such, there is growing interest in the impact of NAFLD on cerebrovascular disease and brain health more broadly. In this review, we assess recent research into understanding the association between NAFLD and brain health while highlighting potential clinical implications. Recent findings Mechanistically, NAFLD is characterized by both a proinflammatory and proatherogenic state, which results in vascular inflammation and neurodegeneration, potentially leading to clinical and subclinical cerebrovascular disease. Mounting epidemiological evidence suggests an association between NAFLD and an increased risk and severity of stroke, independent of other vascular risk factors. Studies also implicate NAFLD in subclinical cerebrovascular disease, such as carotid atherosclerosis and microvascular disease. In contrast, there does not appear to be an independent association between NAFLD and cognitive impairment. Summary The current literature supports the formulation of NAFLD as a multisystem disease that may also have implications for cerebrovascular disease and brain health. Further prospective studies are needed to better assess a temporal relationship between the two diseases, confirm these early findings, and decipher mechanistic links.

Original languageEnglish (US)
Pages (from-to)31-38
Number of pages8
JournalCurrent opinion in lipidology
Issue number1
StatePublished - Feb 1 2022


  • Brain health
  • Cerebrovascular disease
  • Hepatic steatosis
  • Metabolic syndrome
  • Nonalcoholic fatty liver disease

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Molecular Biology
  • Genetics
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine
  • Cell Biology


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