This may be related to oxidative stress, vascular inflammation, and nutritional deficiency (e.g., folic acid, vitamin B, and iron).[15] As a biochemical marker of nutritional and inflammatory status, albumin (ALB), the main substance to maintain plasma osmotic pressure, is synthesized in the liver.[16] ALB exerts a neuroprotective role through anti-inflammatory activity, and antioxidant characteristics, inhibiting endothelial cell apoptosis, and regulating microvascular permeability.[17,18] The RDW/ALB ratio (RAR) is a new combined biomarker based on RDW and ALB. This evidence concerns the gene ALB and nutritional deficiency disease.