Increased concentrations of HNA1 and HNA2 correlate closely with Model for End-Stage Liver Disease score, bilirubin concentration, international normalized ratio, and C-reactive protein concentration.33 In a larger study (N = 2,376 patients hospitalized for cirrhosis but without HE), decreased serum albumin levels were potentially associated with higher risk of overt HE (odds ratio [OR] = 0.878, 95% confidence interval [CI] = 0.834-0.924) and death from overt HE (OR = 0.864, 95% CI = 0.771-0.967).35 This evidence concerns the gene CRP and hereditary elliptocytosis.