From the Guidelines
Low albumin (ALB) levels are prognostically significant and associated with poor outcomes in patients with liver disease, as evidenced by the inclusion of albumin in the Child-Pugh classification and the ALBI score 1. The prognostic significance of low albumin levels is well-established in the context of liver disease, particularly in patients with cirrhosis and hepatocellular carcinoma (HCC).
- The Child-Pugh classification, which includes albumin as one of its parameters, is widely used to assess liver function and predict outcomes in patients with cirrhosis 1.
- The ALBI score, which combines albumin and bilirubin, has been shown to stratify patients across different stages of liver disease and predict outcomes 1.
- Low albumin levels have been associated with increased mortality risk, particularly in elderly populations and those with chronic conditions such as liver disease, heart failure, and kidney disease.
- The European Association for the Study of the Liver Clinical Practice Guidelines endorse the use of the BCLC classification, which includes liver function, tumor status, and performance status, to guide treatment decisions in patients with HCC 1.
- While the evidence is not specific to low albumin levels, the inclusion of albumin in these classification systems and scores highlights its importance as a prognostic factor in patients with liver disease.
- Clinicians should consider evaluating underlying liver disease, malnutrition, or advanced organ dysfunction when encountering low albumin levels, and optimize management of any underlying chronic conditions accordingly.
- The most recent and highest quality study, published in 2018, provides evidence for the prognostic significance of low albumin levels in patients with HCC 1.
From the Research
Prognostic Significance of Low Albumin (ALB)
- The provided studies do not directly address the prognostic significance of low albumin (ALB) levels.
- However, one study 2 mentions low albumin as a factor that is corrected for in a multifactorial model to assess the correlation between low-normal ALT values and increased risk of all-cause mortality.
- The study found that low-normal ALT values were predictive of increased risk of all-cause mortality, even after correcting for factors such as low albumin, suggesting that low albumin may be associated with poor outcomes.
- However, this is not a direct assessment of the prognostic significance of low albumin levels, and more research would be needed to fully understand its implications.
Related Biomarkers
- The studies provided focus on the prognostic significance of alanine aminotransferase (ALT) levels, rather than albumin.
- Elevated ALT levels are associated with liver injury and disease 3, 4, 5, 6.
- Low-normal ALT values have been found to be predictive of increased risk of all-cause mortality in middle-aged adults 2.
- The prognostic significance of low albumin levels is not directly addressed in the provided studies.