The albumin–bilirubin score can reflect disease severity in alcohol-associated hepatitis and cirrhosis

Year 2026, Volume: 8 Issue: 2, 257 - 264, 10.03.2026

Musa Salmanoğlu , Süleyman Baş , Yasemin Armutçuoğlu , İrfan Küçük

https://doi.org/10.38053/acmj.1848023

https://izlik.org/JA59AZ27ME

Abstract

Aims: The albumin-bilirubin (ALBI) score has been evaluated in various liver diseases, however its clinical relevance in alcoholassociated liver disease (ALD) remains unclear. This study aimed to evaluate whether the ALBI score reflects disease severity in patients with alcohol-associated hepatitis (AH) and alcohol-associated cirrhosis (AC).
Methods: In this retrospective case control study, 51 AH patients, 39 AC patients, and 48 healthy controls (HCs) were included. The ALBI score was calculated for all participants. The Child-Pugh classification (CPC A-C) was recorded for AC, while Maddrey’s Discriminant Function (MDF) for AH. The Model for End-Stage Liver Disease Sodium (MELD-Na) score was calculated for both patient groups, and the Fibrosis-4 (FIB-4) index was calculated in all participants.
Results: Mean ALBI scores were highest in the AH patients and the lowest in the HCs (p<0.001). Statistically significant differences were observed between the AH and AC groups, AH and HC groups, and AC and HC groups (all p<0.001). In the AH group, no significant correlation was observed between the ALBIs and MDF, however, ALBI scores showed positive correlations with FIB-4 and MELD-Na scores (p=0.046; p<0.001). Among patients with AC, the lowest mean ALBI scores were observed in the CPC-A subgroup, while the highest were observed in the CPC-C subgroup (p<0.001). ALBI scores were positively correlated with both FIB-4 and MELD-Na scores (p<0.001; p<0.001).
Conclusion: Elevated ALBI scores may have diagnostic value and reflect disease severity and hepatic dysfunction in patients with AH and AC.

Keywords

Albumin-bilirubin score , alcohol-associated cirrhosis , alcohol-associated liver disease

Ethical Statement

ETHICAL DECLARATIONS Ethics Committee Approval: The study was initiated with the approval of the Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital Ethics Committee (Date: 16.02.2024, Decision No: 2024/29). Informed Consent: Written consent was obtained from the patient participating in this study. Conflict of Interest Statement: The authors have no conflicts of interest to declare. Financial Disclosure: The authors declared that this study has received no financial support. Author Contributions: All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version.

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