Albumin-bilirubin score as a useful predictor of energy malnutrition in patients with hepatocellular carcinoma.

Summary Background & aims Chronic liver diseases, including hepatocellular carcinoma (HCC), lead to an imbalance in energy metabolism. The non-protein respiratory quotient (npRQ), which estimates energy malnutrition, can be evaluated using an indirect calorimeter; however, npRQ measurement is limited in routine work. This study aimed to investigate the relationship between the albumin–bilirubin (ALBI) score and npRQ in patients with HCC. Methods We conducted a retrospective cohort study in 109 patients with HCC who underwent indirect calorimetry and then compared the npRQ with various clinical parameters, including liver function and tumor factors. Results The median npRQ was 0.82. A significant negative correlation was found between the npRQ and the ALBI score (r = −0.35, p  Conclusions The ALBI score might be a useful predictor for energy malnutrition in patients with HCC. In addition, most HCC patients with mALBI grade 2b or 3 can be considered to have energy malnutrition.