Evaluation of Metabolic Dysfunction–Associated Steatohepatitisas Risk Factor in Management of Non-diabetic Patients Presenting with Acute Ischemic Stroke

Background: Metabolic dysfunction–associated steatohepatitis (MASH) is linked to an increased risk of cardiovascular diseases, including acute ischemic strokes and diabetes. However, data on MASH as independent risk factor for ischemic stroke severity and functional outcomes remain limited. To evaluate whether Metabolic dysfunction–associated steatohepatitisserves as an independent risk factor and a marker of increased stroke severity at onset as well as its impact on functional recovery in non-diabetic patients. Objective: To evaluate whether Metabolic dysfunction–associated steatohepatitisacts as an independent risk factor contributing to the severity of acute ischemic stroke at presentation and affecting functional recovery outcomes in non-diabetic patients. Methods: This prospective observational cohort, hospital-based study was conducted at Sir Ganga Ram Hospital Lahore, enrolling 54 non-diabetic patients who consented and met inclusion criteria. Patients underwent abdominal ultrasound for MASH screening, with the FIB-4 score calculated from blood samples (age, AST, ALT, and platelet count).27 patients with MASH (GROUP A) were compared to 27 without MASH (GROUP B). The CT scan assessed ischemic stroke at admission, and NIHSS score was recorded. Follow-ups at three and six months involved repeat CT scans and Modified Rankin Score to evaluate disability. Results: The MASH group had significantly higher mean Body Mass Index (BMI) of 38 kg/m² compared to 28.6 kg/m² in the non-MASH group (p=0.001). NIHSS scores were also higher in the MASH group (26.2 vs. 15.5, p=0.001). At three months, the Modified Rankin score averaged 3.52 in the MASH group versus 2.81 in the non-MASH group (p=0.04). Additionally, more MASH patients presented with reduced consciousness (29.6% vs. 7.4%, p=0.03). Conclusion: this study highlights the adverse impact of MASH on ischemic stroke severity and functional outcomes in non-diabetic patients, underscoring the need for tailored management strategies.