白蛋白是最丰富的血浆蛋白，通常使用白蛋白输注。传统上，白蛋白的生物学和治疗作用被认为是由于其胶体渗透特性。然而，白蛋白具有多种生物学功能，包括分子运输、抗氧化、抗炎、内皮稳定、抗血栓作用和毛细血管通透性调节等。尽管如此，白蛋白的功能尚未得到彻底研究。最近的研究表明，非酒精性脂肪性肝病（NAFLD）、病毒性肝炎、肝硬化和肝功能衰竭与白蛋白功能受损有关，而白蛋白功能受损又与肝功能和疾病预后受损有关。白蛋白的翻译后修饰会引起影响蛋白质功能的结构修饰。最近，与正常功能相关的白蛋白浓度，即“有效白蛋白浓度”，引起了越来越多的兴趣。此外，尽管包括白蛋白浓度在内的许多生物标志物被广泛用于肝病患者早期肝功能障碍的评估，但预测价值并不令人满意。然而，临床证据表明，白蛋白功能可能代表肝功能早期损伤的新生物标志物。在这篇综述中，我们总结了影响白蛋白功能的因素，并讨论了各种肝脏疾病中白蛋白功能受损的临床意义。关键信息白蛋白的重要性不仅取决于其浓度，还取决于其各种生理功能。白蛋白功能受损在多种肝脏疾病中均有报道，且与疾病严重程度和预后相关，从而提出“有效白蛋白浓度”的概念。白蛋白功能障碍比其他常规指标出现得更早，白蛋白功能障碍可能是一种新的生物标志物许多外源性和内源性因素导致白蛋白翻译后修饰，改变白蛋白的三维结构，导致其生物活性降低。
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Impaired albumin function: a novel potential indicator for liver function damage?
Albumin is the most abundant plasma protein and albumin infusion is commonly used. Conventionally, the biologic and therapeutic effects of albumin have been thought to be due to its oncotic properties. However, albumin has a variety of biologic functions, including molecular transport, anti-oxidation, anti-inflammation, endothelial stabilisation, anti-thrombotic effects, and the adjustment of capillary permeability. Despite this, the functions of albumin have not been thoroughly investigated. Recent studies have shown non-alcoholic fatty liver disease (NAFLD), viral hepatitis, cirrhosis, and liver failure to be associated with impairments in albumin function, which are associated with impairments in liver function and disease prognosis. Post-translational modifications of albumin cause structural modifications that affect protein function. Recently, the concentration of albumin associated with normal function, the 'efficient albumin concentration', has been attracting more interest. In addition, although many biologic markers, including albumin concentration, are widely used for the assessment of early liver dysfunction in patients with liver diseases, the predictive values are unsatisfactory. However, clinical evidence has suggested that albumin function may represent a novel biomarker of early impairment in liver function. In this review, we summarise the factors affecting albumin function and discuss the clinical significance of impairments in albumin function in various liver diseases.Key messagesThe importance of albumin depends not only on its concentration, but also on its various physiological functions.Impaired albumin function has been reported in a variety of liver diseases, and is associated with disease severity and prognosis, thereby proposing the concept of 'effective albumin concentration'.Albumin dysfunction occurs earlier than other conventional indicators, and albumin dysfunction may be a new biomarker of early impairment in liver function.Many exogenous and endogenous factors lead to post-translational modifications of albumin, which alters the three-dimensional structure of albumin, resulting in a decrease in its biological activity.
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