On the other hand, Baron M et al. demonstrated that although more than 20% of their systemic sclerosis cohort was at high risk for malnutrition, only 2% of them had low albumin levels; they suggested that low serum albumin level may not be a useful marker for malnutrition because patients with malnutrition may have normal albumin levels in chronic diseases [6]. This evidence concerns the gene ALB and nutritional deficiency disease.