Previous studies have shown that PBC patients with ALP ≥ 2 ȕ upper limit of normal (ULN) and bilirubin (ALB) > 1 mg/dL were more likely to develop clinical endpoints23 and baseline ALB, advanced histologic stage and Mayo risk score (MRS) > 4.5 have been identified as the independent prognostic factors of PBC9, 24. Here, ALB is linked to primary biliary cholangitis.