Abstract：
Studies have indicated that reduced serum ALT levels are commonly linked to aging and are known to predict poor outcomes in many clinical conditions as potential frailty indicators. There are close connections between the brain and peripheral organs, particularly the liver. In patients with acute ischemic stroke (AIS), the interactive effects may change ALT levels, which in turn influence stroke outcomes. Whether ALT has potential neuroprotective effects or is an indicator of frailty in AIS patients remains unknown. This retrospective analysis examined 572 AIS patients in Beijing Luhe Hospital between August 2020 and June 2021. Patient demographics and laboratory results were assembled. The National Institutes of Health Stroke Scale (NIHSS) was used to analyze stroke severity. Modified Rankin Score (mRS) determined stroke outcome 3 months after AIS, with mRS≤2 indicating a favorable outcome. Based on serum ALT measurements, patients were classified into three tertiles (T1-T3). Binary logistic regression analysis evaluated the correlation between ALT tertiles and AIS outcomes. Of the patients, 66 exhibited unfavorable outcomes. The median ALT level in this group was 13 (IQR: 11-18.25), which was lower than in the favorable outcomes cohort (16; IQR: 11-22). A decline in ALT corresponded with a higher incidence of poor outcomes at 3 months (T1, 15.5 %; T2, 11.4 %; T3, 7.0 %; p = 0.03). The lowest ALT tertile (T1) was independently linked to an adverse 3-month outcome (OR 2.50 95 %CI 1.24-5.07, p = 0.038) compared to the highest tertile. ALT levels demonstrated no correlation with age (T1, 62.59 ± 12.64; T2, 64.01 ± 11.47; T3, 65.12 ± 11.27; p > 0.05). Regardless of age, lower serum ALT levels are independently associated with poorer outcomes in AIS patients. This finding suggests the potential pivotal part of the liver in AIS outcomes, highlighting the need to consider both neurological and liver functions post-stroke.
摘要：
研究表明，降低血清ALT水平通常与衰老有关，并且已知在许多临床条件下预测不良结果作为潜在的虚弱指标。大脑和周围器官之间有着密切的联系，尤其是肝脏。在急性缺血性卒中（AIS）患者中，交互效果可能会改变ALT水平，这反过来又影响中风的结果。ALT是否具有潜在的神经保护作用或AIS患者的虚弱指标仍然未知。这项回顾性分析检查了2020年8月至2021年6月在北京六河医院接受的572例AIS患者。收集患者的人口统计学和实验室结果。美国国立卫生研究院卒中量表(NIHSS)用于分析卒中严重程度。改良Rankin评分（mRS）确定AIS后3个月的卒中结局，mRS≤2表示有利的结果。基于血清ALT测量，患者被分为三三分位数(T1-T3).二元logistic回归分析评估ALT三元率与AIS结果之间的相关性。在患者中，66显示出不利的结果。本组ALT水平中位数为13（IQR：11-18.25），低于有利结局队列(16；IQR：11-22)。ALT的下降与3个月时不良结局的发生率较高（T1，15.5％；T2，11.4％；T3，7.0％；p=0.03）。与最高的三元组相比，最低的ALT三元组（T1）与不良的3个月结局（OR2.5095CI1.24-5.07，p=0.038）独立相关。ALT水平与年龄无关(T1,62.59±12.64;T2,64.01±11.47;T3,65.12±11.27;p>0.05)。不管年龄,在AIS患者中,较低的血清ALT水平与较差的预后独立相关.这一发现表明AIS结果中肝脏的潜在关键部分，强调中风后需要同时考虑神经功能和肝功能。
