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Introduction
Liver is the largest substantive organ of human body, bearing numerous important and complex physiological functions. It is not only the metabolic center of numerous substances, but also has a variety of physiological functions such as detoxification and immune regulation (1). Chronic liver disease (CLD) is one of the leading causes of death globally, and the associated burden is also rising (2). In recent years, due to changes in lifestyle and dietary habits, the incidence and prevalence of non-alcoholic fatty liver disease (NAFLD) have been increasing (3), and it has gradually become the most common cause of CLD. At present, ~25% of the global population is considered to have NAFLD (4). The risk of liver disease increases as excessive consumption of alcohol increases (5). The number of deaths caused by end-stage liver disease worldwide even is as numerous as 2 million each year (6). At present, liver disease has gradually developed into a global public health problem, and the prevention and treatment of this disease will be the top priority.
At the same time, the liver is also the hub of plasma protein synthesis, glucose and lipid metabolism. It has been suggested that metabolic reprogramming in the liver may influence the progression of liver disease (7). However, albumin, an important protein synthesized and metabolized in the liver, has always been the focus of attention. Its effects on the liver are still being explored. It is known to be introduced as a therapy for the management of hypoalbuminemia and ascites in patients with cirrhosis because of its ability to maintain plasma oncotic pressure (8). Subsequently, numerous clinical trials have found that albumin infusion is beneficial in the treatment of other complications of liver cirrhosis, which can improve the prognosis and/or survival of patients with spontaneous bacterial peritonitis (SBP) (9,10) and hepatorenal syndrome (HRS) (11,12). These benefits have drawn attention to the role of albumin in the organism.
However, due to the incomplete understanding of its structure and function, the use of albumin is also controversial (13,14). When Jalan et al (15) verified the correlation between albumin therapy and its function, it was found that not only the quantity of albumin was reduced, but also the quality of albumin was damaged in patients with...