摘要
Metabolic-associated steatotic liver disease(MASLD)has become the leading cause of chronic liver disease worldwide,yet reliable tools for prognostication remain limited.Fibrosis-based indices such as the fibrosis-4 and nonalcoholic fatty liver disease fibrosis score are widely used but primarily reflect structural damage rather than functional decline.The albumin-bilirubin(ALBI)score,originally established to assess hepatic reserve in patients with hepatocellular carcinoma,provides a simple and objective measure of liver function derived from routine laboratory parameters.Recent validation and meta-analytic studies have shown that ALBI predicts liver-related outcomes and all-cause mortality across diverse chronic liver disease populations,including MASLD,and offers complementary prognostic information beyond fibrosis-based models.Its simplicity,cost-effectiveness,and compatibility with automated reporting systems make it feasible for integration into clinical workflows and population-level risk stratification.However,interpretation of ALBI should consider potential confounders such as renal dysfunction,inflammation,and Gilbert syndrome,and threshold calibration across ethnic groups remains necessary.The ALBI score represents a promising functional biomarker that could enhance risk prediction and care pathways in MASLD,although prospective,multiethnic,and longitudinal studies remain needed to confirm its prognostic value and define clinically meaningful cut-offs.
