This article is more than 5 years old. Information may no longer be current.

Liver fibrosis associated with presence of cerebral microbleeds

Researchers found that liver fibrosis was associated with the presence of cerebral microbleeds among a cohort of Korean adults, according to published findings.

“Liver fibrosis is a multifactorial disease associated with systemic inflammation, insulin resistance and arterial stiffness, all of which can affect cerebral small vessels,” the researchers wrote. “Thus, a significant correlation may exist between the severity of cerebral [small vessel diseases] and liver fibrosis. … The aim of this study was to determine whether the severity of cerebral [small vessel diseases] depends on the degree of liver fibrosis, as reflected by [liver stiffness] values using [transient elastography].”

Three hundred healthy Korean adults (mean age, 56 years) who underwent a comprehensive medical check-up between January 2011 and December 2012 at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, were included in the study and underwent transient elastography (TE) for liver stiffness measurement. TE was performed on the right lobe of the liver using an M probe, according to the research. The presence of small vessel disease, such as cerebral microbleeds (CMBs), silent infarction and leukoaraiosis, was measured through MRI.

Among all the patients, the prevalence of mild fibrosis was 15% and significant fibrosis was 4%. Also, 21.3% had CMBs in any location (n = 64), with a majority having just one (n = 55). Leukoaraiosis was found in 66.7% of all patients (n = 200) and 8.7% of patients had silent infarctions (n = 26). The mean liver stiffness (LS) value was 4.8 ± 2.3 kPa.

Leukoaraiosis and silent infarctions were not found to be significantly associated with LS values or the degree of liver fibrosis (P > .05 for both). Patients with a greater amount of CMBs had higher LS values (P < .001); patients with no CMBs had an LS value of 4.5 ± 1.5 vs. patients with three CMBs with an LS value of 12.4 ± 10.7.

In addition to higher LS values, patients with CMBs were more likely male, older and had a higher degree of liver fibrosis compared to patients without CMBs (P < .05 for all).

Multivariate analyses showed fibrosis to be a positive independent predictor for the presence of CMBs (OR = 6.165; 95% CI, 1.53-24.839). In addition, the degree of liver fibrosis was found to be positively associated with the presence of CMBs in patients aged 60 years or older.

Univariate analysis also showed a positive association between fibrosis and the presence of CMBs in patients younger than age 60 years (P = .011) and patients older than age 60 years (P = .055).

“The degree of liver fibrosis, as assessed using transient elastography, was independently associated with the presence and burden of CMBs in healthy, asymptomatic participants,” the researchers concluded. “Understanding the link between the brain and liver may advance future research on the pathomechanisms of CMBs.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.