Gut microbiota alterations are associated with functional outcomes in patients of acute ischemic stroke with non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease (NAFLD) is a risk factor for adverse prognosis of acute ischemic stroke (AIS) and a common comorbidity in patients with AIS. However, the mechanisms by which NAFLD increases the risk of the adverse prognosis remain unknown. This study explored the changes in gut microbiota of AIS patients with NAFLD to expand the understandings of their mechanisms from the perspective of gut microbiota. Methods Patients were recruited and divided into 2 groups comprising 64 patients with AIS and NAFLD and 85 patients with AIS but without NAFLD. The stool samples and clinical information were collected. 16s rRNA sequencing was used to analyze the composition of gut microbiota. The patients were followed-up at 3 months post-stroke. The adverse outcome was assessed by modified Rankin Scale. The changes in microbial composition and key bacteria were assessed, and potential microbial marker for predicting risks for the adverse prognosis in AIS patients with NAFLD based on receiver operating characteristic curve was identified. Results The relative abundance of Dorea , Dialister , Intestinibacter , Flavonifractor significantly decreased in NAFLD group, while the relative abundance of Enorma significantly increased in NAFLD group. Dorea was identified as the potential microbial marker for predicting the risk of adverse prognosis in AIS patients with NAFLD (area under the curve > 0.600). Conclusions This study demonstrated comprehensively gut microbiota characteristics in AIS patients with NAFLD, screened out crucial microbe related to adverse prognosis, and identified the potential microbial marker for predicting the risk of AIS patients with NAFLD.