Evaluation and Validation of the Prognostic Value of Serum Albumin to Globulin Ratio in Patients With Cancer Cachexia: Results From a Large Multicenter Collaboration

Xie, Hailun; Zhang, Qi; Ruan, Guo‐Tian; Ge, Yi‐Zhong; Hu, Chunlei; Song, Mengmeng; Song, Chunhua; Zhang, Xi; Li, Xiangrui; Zhang, Kang‐Ping; Liu, Tong; Yang, Ming; Tang, Meng; Xu, Hongxia; Shi, Hanping

doi:10.3389/fonc.2021.707705

Cited by 23 publications

(21 citation statements)

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“…The AGR, which takes both albumin and globulin into account, is a convenient serological indicator to identify serum protein abnormalities [ 27 ]. Several studies indicated that it could reflect not only a change in nutritional condition, but also a medium to long-term inflammatory status [ 27 , 28 ]. Literatures reported AGR could serve as a diagnostic biomarker for infection diseases, or a prognostic marker for various types of cancer [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between albumin, globulin, albumin to globulin ratio and muscle mass in adults: results from the national health and nutrition examination survey 2011–2014

et al. 2022

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Introduction Chronic inflammation and malnutrition play important roles in muscle loss. Although albumin, globulin and albumin to globulin ratio (AGR) are considered to be useful inflammatory-nutritional biomarkers, their relationship with muscle mass remain unclear. This study aimed to investigate the relationship between them in adults. Methods We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 for analysis. Data on albumin, globulin, appendicular skeletal muscle mass, body mass index (BMI) and potential confounders (sociodemographic characteristics, medical conditions, laboratory parameters) were extracted and analyzed. We conducted multivariate linear regression models and smooth curve fittings to investigate the association between albumin, globulin, AGR and muscle mass. Subgroup analysis based on gender and muscle mass were performed. Results A total of 4110 participants were included, there were 294 participants with low muscle mass (LMM) and 3816 participants with normal muscle mass (NMM). LMM individuals were older, had greater prevalence of diabetes, higher BMI, globulin and triglycerides, lower albumin and AGR. Albumin was positively correlated to muscle mass in men, but negatively correlated with muscle mass in women. There were negative association between globulin and muscle mass, and positive association between AGR and muscle mass among men, but no significant associations were detected among women. Moreover, a linear relationship between albumin, globulin and muscle mass, as well as a non-linear relationship between AGR and muscle mass in men were identified. Conclusions The relationships between albumin, globulin, AGR and muscle mass were sex-specific. We speculate these indicators may be useful in assessing muscle mass in men.

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Section: Discussionmentioning

confidence: 99%

Associations between albumin, globulin, albumin to globulin ratio and muscle mass in adults: results from the national health and nutrition examination survey 2011–2014

et al. 2022

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“…Serum albumin and globulin reflect the nutritional and inflammatory status of individuals and have shown potential prognostic value in a variety of tumors ( 39 – 41 ). On the one hand, albumin reflects the nutritional status of individuals, and in general, patients with poor nutritional status have a higher risk of postoperative complications, which may greatly shorten the survival time of cancer patients ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

A Nutritional Metabolism Related Prognostic Scoring System for Patients With Newly Diagnosed Osteosarcoma

et al. 2022

Front. Nutr.

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Osteosarcoma is a primary malignant bone tumor with high metastatic potential. To date, achieving long-term survival of osteosarcoma patients remains a difficult task. Metabolic reprogramming has emerged as a new hallmark of cancer. However, studies on the prognostic value of hematological markers related to nutritional and metabolism in cancer patients are limited and contradictory. In this retrospective study, we extensively collected 16 hematological markers related to nutritional and metabolism in 223 osteosarcoma patients. A nutritional metabolism related prognostic scoring system (NMRS) in patients with osteosarcoma was constructed by least absolute contraction and selection operator (LASSO) cox regression analysis. Compared with individual hematological indicators, NMRS has stronger predictive power (training set: 0.811 vs. 0.362–2.638; validation set: 0.767 vs. 0.333–0.595). It is an independent prognostic factor for the survival of patients with osteosarcoma [HR: 1.957 (1.375–2.786) training set; HR: 3.146 (1.574–6.266) validation set]. NMRS-based nomograms have good and stable predictive power. NMRS facilitates further risk stratification of patients with the same clinical characteristics.

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“…Blood samples were collected to measure serum markers, namely, CRP, neutrophils (N), lymphocytes (L), platelets (P), glucose (Glu), albumin (ALB), and globulin (GLB). These baseline inflammatory markers constituted the following ratios and indices: NLR (N/L ratio) ( 13 ), PLR (P/L ratio) ( 13 ), prognostic nutrition index (PNI), 10 × ALB + 0.005 × L) ( 13 ), systemic immune-inflammation index (SII), P × NLR) ( 13 ), ALI (BMI × ALB/NLR) ( 13 ), CAR (CRP/ALB ratio) ( 17 ), AGR (ALB/GLB ratio) ( 18 ), LCR (L/CRP ratio) ( 14 ), GNRI (1.489 × ALB + [Present body weight (PBW)/Ideal body weight (IBW)]) ( 12 ), mGNRI (modified GNRI, 1.489 × CRP + 41.7 × PBW/IBW) ( 12 ), and nutritional risk index (NRI), 1.519 × ALB + 41.7 × PBW/IBW) ( 19 ). IBW was evaluated using the Lorentz equation: men = height (cm) − 100 − [(height − 150)/4]; women = height (cm) − 100 − [(height − 150)/2.5] ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Assessment Of Inflammatory Markersmentioning

confidence: 99%

A Novel Systemic Inflammation Prognostic Score to Stratify Survival in Elderly Patients With Cancer

et al. 2022

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BackgroundElderly patients with cancer face the challenge of systemic inflammation, which can lead to a poor prognosis. Existing inflammatory indices cannot fully reflect the immune-inflammatory status of patients. This study aimed to develop a new scoring system to predict the survival of elderly patients with cancer using inflammatory indices, namely, the systemic inflammation prognostic score (SIPS).Materials and MethodsThis prospective multicenter study included a total of 1,767 patients with cancer, with a mean age of 70.97 ± 5.49 years, of whom 1,170 (66.2%) were men. We performed the least absolute shrinkage and selection operator (LASSO) regression to screen inflammatory indicators to include in constructing SIPS. Prognostic analysis of SIPS was performed using univariate and multivariate survival analyzes. The prognostic value of SIPS and its components were compared using the prognostic receiver operating characteristic curve and concordance index. The population was divided into the training cohort and the validation cohort in a 7:3 ratio and a SIPS prognostic analysis was performed.ResultsThe LASSO regression selected C-reactive protein (CRP) (≤ 9.81, “0”; > 9.81, “1”), geriatric nutritional risk index (GNRI) (≤ 93.85, “1”; 93.85, “0”), advanced lung cancer inflammation index (ALI) (≤ 23.49, “1”; > 23.49, “0”), and lymphocyte to C-reactive protein ratio (LCR) (≤ 2523.81, “1”; > 2523.81, “0”) to develop SIPS. Patients were divided into the three groups based on the total SIPS: low-risk (0), moderate-risk (1–2), and high-risk (3–4). On the multivariate survival analysis, patients in the moderate-risk [P < 0.001, hazard ratio (HR) = 1.79, 95% CI: 1.47–2.17] and high-risk groups (P < 0.001, HR = 2.40, 95% CI: 1.98–2.92) showed a worse prognosis than those in the low-risk group. The total cohort, training cohort, and validation cohort all showed that SIPS had better survival prediction than CRP, GNRI, ALI, and LCR. The HRs were 2.81 times higher in patients in the high-risk group with malnutrition than in patients in the low-risk group without malnutrition.ConclusionSIPS was an independent prognostic indicator in elderly patients with cancer. Malnutrition in the high-risk group increased the mortality risk.

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Evaluation and Validation of the Prognostic Value of Serum Albumin to Globulin Ratio in Patients With Cancer Cachexia: Results From a Large Multicenter Collaboration

Cited by 23 publications

References 23 publications

Associations between albumin, globulin, albumin to globulin ratio and muscle mass in adults: results from the national health and nutrition examination survey 2011–2014

Associations between albumin, globulin, albumin to globulin ratio and muscle mass in adults: results from the national health and nutrition examination survey 2011–2014

A Nutritional Metabolism Related Prognostic Scoring System for Patients With Newly Diagnosed Osteosarcoma

A Novel Systemic Inflammation Prognostic Score to Stratify Survival in Elderly Patients With Cancer

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