Non-alcoholic fatty liver disease and acute cerebrovascular insufficiency — is there a relationship between them?

Aim: to submit available data on a potential relationship between non-alcoholic fatty liver disease (NAFLD) and acute cerebrovascular disease (ACVD). A correlation between thickness of the intima media of the carotid artery and non-alcoholic steatohepatitis is reported. It was noted that progressive liver fibrosis is significantly associated with a high risk of carotid artery intima-media thickening in patients with NAFLD, and that a history of ischemic ACVD worsens their prognosis. The role of genetic factors (in particular, a PNPLA3 GG genotype) associated with a higher severity of carotid atherosclerosis in young NAFLD patients is highlighted. The author demonstrated that liver fibrosis + steatosis was independently associated with progressive carotid atherosclerosis and an increased risk of ACVD in patients with diabetes mellitus. It was noted that a high FIB-4 index was a significant predictor of recurrent ischemic stroke in males. The data demonstrating NAFLD involvement in occurrence and development of ischemic stroke through intestinal microbiota are submitted. Due to a pathogenetically justified effect, it has been proven necessary to add infusion solutions (in particular, inosine + meglumine + methionine + nicotinamide + succinic acid) protecting the cell membrane from oxidative stress factors in NAFLD therapy. The product significantly reduces clinical and biochemical manifestations of NAFLD. Due to a high risk of endothelial dysfunction and oxidative stress in patients with ACVD + NAFLD, a risk of unfavorable course significantly increases in a poststroke period. This justifies early prescription of neuroprotectors at the first stage of rehabilitation to increase mobilization efficiency in these patients. Inosine + nicotinamide + riboflavin + succinic acid, intravenous solution and enteric-coated tablets, is the only drug of this group included in the clinical guidelines. KEYWORDS: non-alcoholic fatty liver disease, acute cerebrovascular disease, liver fibrosis, Remaxol, Cytoflavin, inosine, meglumine, methionine, nicotinamide, succinic acid, riboflavin. FOR CITATION: Akhmedov V.A. Non-alcoholic fatty liver disease and acute cerebrovascular insufficiency — is there a relationship between them? Russian Medical Inquiry. 2025;9(5):285–290 (in Russ.). DOI: 10.32364/2587-6821-2025-9-5-5