Although multivariate Cox analysis using TC as a continuous variable revealed no significant association with survival (Supplementary Figure 1), analysis using TC as a categorical variable demonstrated that the level of TC in group 2 decreased the risk of mortality of patients with MSA compared to the level of TC in group 1, after adjusting for age, sex, subtype, BMI, disease duration, total UMSARS score, OH, diabetes, hypertension, albumin, TG, HDL-C and LDL-C (HRs and 95% CIs of group 2: 0.47, [0.23–0.96]; group 1 for reference; p = 0.038). Here, ALB is linked to multiple system atrophy.