ALB and metabolic dysfunction-associated steatotic liver disease: However, the following points should be noted: (1) the inclusion criteria for BCAA use in patients with cirrhosis in the aforementioned Japanese study [24] defined a low albumin concentration as ≤3.5 g/dL, so its usefulness in patients with NAFLD, including those without cirrhosis, remains unclear, and (2) in most countries, oral BCAA supplements are not reimbursed, and the combination of cost and poor palatability may affect compliance [27].