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The following is a summary of “Association between risk of ischemic stroke and liver enzymes levels: a systematic review and meta-analysis,” published in the January 2025 issue of Neurology by El-Sayed et al. 

Ischemic stroke is a leading cause of global morbidity and mortality. Recent studies suggest a potential link between liver enzyme alterations and increased stroke risk. 

Researchers conducted a retrospective study to examine the potential role of liver enzymes as biomarkers for ischemic stroke.  

They systematically searched four databases for studies on liver enzymes and ischemic stroke up to March 20th, 2024. The Newcastle Ottawa Scale assessed study quality, while risk ratio (RR), hazard ratio (HR), or odds ratio (OR) were extracted and analyzed using RevMan and R software. The certainty of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) system. 

The results showed that increased gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels were significantly associated with higher ischemic stroke risk (RR: 1.43, 95% CI: [1.30 to 1.57], P < 0.00001; RR: 1.60, 95% CI: [1.22 to 2.10], P = 0.0006). In contrast, increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels showed no significant association (RR: 0.92, 95% CI: [0.68 to 1.24], P = 0.58; RR: 1.43, 95% CI: [0.83 to 2.49], P = 0.20). The certainty of evidence was low or very low for all outcomes. 

Investigators concluded that GGT and ALP levels could serve as potential biomarkers for increased ischemic stroke risk, warranting careful follow-up. However, no such association was found for AST and ALT levels. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03875-x#Abs1