Sano A, et al. - Here, physicians explained the profiles of plasma-free amino acids (PFAAs) and the relationship between serum albumin (sAlb) and plasma-free amino acids (PFAAs) in recent patients with chronic liver disease (CLDs) during the progression. The level of total plasma-branched chain amino acids (pBCAAs) was independently associated with the sAlb level in the PFAAs of chronic hepatitis C virus, primary biliary cholangitis and non-alcoholic fatty liver disease/steatohepatitis (NAFLD/NASH), although a decrease in the level of pBCAAs was observed during the progression regardless of the CLD etiology. Among the patients with CLDs, the correlation between sAlb and pBCAAs-to-Tyrosine ratio (BTR) showed the highest value in PBC patients. Even when the sAlb level was kept in the normal range, a decrease in pBCAAs often occurred in NASH.