Liver Dysfunction Assessed by Albumin – Bilirubin (ALBI) Score is Associated with Disturbed Cholesterol Profiles and Reduced Survival in Patients with Chronic Limb-Threatening Ischemia
Abstract
AIMS: Liver dysfunction may affect chronic limb-threatening ischemia (CLTI) outcomes, but its impact on survival and lipid profiles is unclear. To assess the association of liver dysfunction using the Albumin-Bilirubin (ALBI) score, with survival, liver fibrosis, and cholesterol in CLTI patients. METHODS: We retrospectively analyzed single-center data of CLTI patients with below-knee lesions between 2008-2018. ALBI scores were calculated from serum albumin and total bilirubin. Optimal cutoff for 3-year overall survival (OS) was determined by receiver operating characteristic (ROC) analysis, dividing patients into high and low ALBI groups. Patient characteristics, cholesterol, and liver fibrosis (FIB-4 index) were compared, with primary endpoint being 3-year OS. RESULTS: Among 263 patients, high ALBI patients (≥ -2.36, n = 135) were older (80 vs. 72 years), included fewer males (55% vs. 71%), had higher prevalence of bed-ridden status (44% vs. 2%) and heart failure (25% vs. 8%; all P＜0.01). They had higher FIB-4 index (2.49 vs. 1.76), lower total cholesterol (147 vs. 173 mg/dL), HDL-C (43 vs. 56 mg/dL), LDL-C (83 vs. 108 mg/dL), and higher LDL-C/HDL-C ratio (2.57 vs. 2.20; P＜0.01). Three-year OS was lower in high ALBI group (36% vs. 57%; P＜0.01) and remained lower after propensity matching (43% vs. 55%; P = 0.04). Multivariate analysis identified low body mass index (BMI), heart failure, high ALBI score and high FIB-4 index (≥ 1.3) and low LDL-C (＜100 mg/dL) as predictors of poor OS. CONCLUSIONS: High ALBI scores in CLTI patients links to liver fibrosis, disturbed lipid profiles, and reduced survival.
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BibTeX
@article{inoue2026liver,
title = {{Liver Dysfunction Assessed by Albumin – Bilirubin (ALBI) Score is Associated with Disturbed Cholesterol Profiles and Reduced Survival in Patients with Chronic Limb-Threatening Ischemia}},
author = {Kentaro Inoue and Shinichiro Yoshino and Yutaka Matsubara and Tadashi Furuyama and Toshihiro Onohara},
journal = {Journal of Atherosclerosis and Thrombosis},
year = {2026},
month = oct,
doi = {10.5551/jat.66098},
url = {https://www.jstage.jst.go.jp/article/jat/33/10/33_66098/_article},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Liver Dysfunction Assessed by Albumin – Bilirubin (ALBI) Score is Associated with Disturbed Cholesterol Profiles and Reduced Survival in Patients with Chronic Limb-Threatening Ischemia
AU - Kentaro Inoue
AU - Shinichiro Yoshino
AU - Yutaka Matsubara
AU - Tadashi Furuyama
AU - Toshihiro Onohara
PY - 2026
DA - 2026/10/01
JO - Journal of Atherosclerosis and Thrombosis
DO - 10.5551/jat.66098
UR - https://www.jstage.jst.go.jp/article/jat/33/10/33_66098/_article
AB - AIMS: Liver dysfunction may affect chronic limb-threatening ischemia (CLTI) outcomes, but its impact on survival and lipid profiles is unclear. To assess the association of liver dysfunction using the Albumin-Bilirubin (ALBI) score, with survival, liver fibrosis, and cholesterol in CLTI patients. METHODS: We retrospectively analyzed single-center data of CLTI patients with below-knee lesions between 2008-2018. ALBI scores were calculated from serum albumin and total bilirubin. Optimal cutoff for 3-year overall survival (OS) was determined by receiver operating characteristic (ROC) analysis, dividing patients into high and low ALBI groups. Patient characteristics, cholesterol, and liver fibrosis (FIB-4 index) were compared, with primary endpoint being 3-year OS. RESULTS: Among 263 patients, high ALBI patients (≥ -2.36, n = 135) were older (80 vs. 72 years), included fewer males (55% vs. 71%), had higher prevalence of bed-ridden status (44% vs. 2%) and heart failure (25% vs. 8%; all P＜0.01). They had higher FIB-4 index (2.49 vs. 1.76), lower total cholesterol (147 vs. 173 mg/dL), HDL-C (43 vs. 56 mg/dL), LDL-C (83 vs. 108 mg/dL), and higher LDL-C/HDL-C ratio (2.57 vs. 2.20; P＜0.01). Three-year OS was lower in high ALBI group (36% vs. 57%; P＜0.01) and remained lower after propensity matching (43% vs. 55%; P = 0.04). Multivariate analysis identified low body mass index (BMI), heart failure, high ALBI score and high FIB-4 index (≥ 1.3) and low LDL-C (＜100 mg/dL) as predictors of poor OS. CONCLUSIONS: High ALBI scores in CLTI patients links to liver fibrosis, disturbed lipid profiles, and reduced survival.
SN - 1880-3873
SN - 1340-3478
ER -