Tang Tao, Feng Yu, Thomas Aline M, Li Shen
Department of Neurology and Psychiatry, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Heart Lung. 2025 Sep-Oct;73:207-213. doi: 10.1016/j.hrtlng.2025.05.019. Epub 2025 Jun 4.
Liver dysfunction plays a significant role in cardiovascular disease (CVD), yet it lacks effective and practical clinical biomarkers for CVD screening. Albumin-bilirubin (ALBI) score, a novel liver impairment biomarker, has demonstrated significant prognostic value in heart failure.
To evaluate the association between the ALBI score and cardiovascular risk.
This nationally representative study included adults 20 years or older in age from the National Health and Nutritional Examination Survey 2001-2018. ALBI score was calculated using the formula (log bilirubin [umol/L] * 0.66 - 0.85 * albumin [g/dL]). Outcomes were CVD prevalence and mortality. Weighted multivariable regression analyses were performed to determine the associations between ALBI score and outcomes.
Data for 43194 adults were analyzed. A total of 4923 CVD were initially identified, and 1878 CVD-related deaths occurred over an average follow-up period of 8.9 years. A per standard deviation higher ALBI score was associated with an elevated CVD prevalence (OR 1.18, 95 % CI 1.13-1.23) and mortality (HR 1.25, 95 % CI 1.17-1.33). The odds ratios for CVD prevalence comparing the second or highest tertile to the lowest tertile of ALBI scores were 1.12 (95 % CI 0.99-1.26) and 1.35 (95 % CI 1.21-1.51), respectively (P for trend < 0.001). The corresponding hazard ratios for CVD mortality were 1.05 (95 % CI 0.88-1.26) and 1.31 (95 % CI 1.12-1.53), respectively (P for trend < 0.001).
A higher ALBI score was associated with an increased risk of CVD prevalence and mortality among US adults. The ALBI score of liver dysfunction may serve as an effective marker for CVD risk stratification.
肝功能不全在心血管疾病（CVD）中起着重要作用，但缺乏用于CVD筛查的有效且实用的临床生物标志物。白蛋白-胆红素（ALBI）评分是一种新型的肝损伤生物标志物，已在心力衰竭中显示出显著的预后价值。
评估ALBI评分与心血管风险之间的关联。
这项具有全国代表性的研究纳入了2001 - 2018年国家健康与营养检查调查中20岁及以上的成年人。使用公式（log胆红素[微摩尔/升] * 0.66 - 0.85 * 白蛋白[克/分升]）计算ALBI评分。结局指标为CVD患病率和死亡率。进行加权多变量回归分析以确定ALBI评分与结局之间的关联。
分析了43194名成年人的数据。最初共识别出4923例CVD，在平均8.9年的随访期内发生了1878例CVD相关死亡。ALBI评分每升高一个标准差与CVD患病率升高（OR 1.18，95%CI 1.13 - 1.23）和死亡率升高（HR 1.25，95%CI 1.17 - 1.33）相关。将ALBI评分的第二或最高三分位数与最低三分位数相比，CVD患病率的比值比分别为1.12（95%CI 0.99 - 1.26）和1.35（95%CI 1.21 - 1.51）（趋势P < 0.001）。CVD死亡率的相应风险比分别为1.05（95%CI 0.88 - 1.26）和1.31（95%CI 1.12 - 1.53）（趋势P < 0.001）。
较高的ALBI评分与美国成年人中CVD患病率和死亡率风险增加相关。肝功能不全的ALBI评分可能作为CVD风险分层的有效标志物。
