Several studies have focused on the association between a low ALB/ALP ratio and poorer overall survival.[16,17,32] To our knowledge, this is the first time that the association between ALB and ALP in patients with cancer has been assessed using different multivariate logistic regression models, and the robustness of the results has been confirmed by subgroup analysis stratified by sex, ethnicity, liver disease, arthritis, and gout. Here, ALB is linked to gout.