ALB and chronic obstructive pulmonary disease: CHB interferes with apoptosis signaling pathways,64,65 and oxidative stress may contribute to liver disease progression in CHB patients.66–68 Similar to chronic obstructive pulmonary disease, apoptosis in the quadriceps of CHB patients might impair muscle function,69 while oxidative stress could affect functional capacity.30,60 Although albumin, non-conjugated bilirubin, and uric-acid values were comparable between groups, suggesting maintained oxidant-antioxidant balance, the oxidative stress factor cannot be completely ruled out in explaining the 6MWD decline.