Serum Albumin to Globulin Ratio is Associated with the Presence and Severity of Inflammatory Bowel Disease

Abstract

Objective Serum albumin to globulin ratio (AGR) is a marker of inflammatory disease, but its role in inflammatory bowel disease (IBD) remains unknown. The primary purpose of the present research was to explore the relationship between serum AGR and inflammatory bowel disease (IBD). Methods A total of 179 patients with ulcerative colitis (UC), 210 patients with Crohn’s disease (CD), and non-IBD controls (age- and gender-matched controls who have gastrointestinal (GI) symptoms) were enrolled in the research. Demographic data, endoscopic score, and serum biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and Ca 2+ were included. The Mayo score and the Harvey-Bradshaw Index (HBI) were applied to evaluate the disease activity of UC and CD, respectively. Results Serum AGR was significantly lower among IBD patients compared with non-IBD controls. There was a negative association between serum AGR and Mayo score in patients with UC (r = −0.413, p < 0.001), and serum AGR was also associated with HBI score in patients with CD (r = −0.471, p < 0.001). After adjusting other potential variables, low serum AGR (below-median) was independently associated with Mayo score ( β = −0.196, p = 0.026) and HBI score ( β = −0.162, p = 0.022), respectively. The area under the curve (AUC) for AGR to distinguish UC was 0.701, and the AUC of CD was 0.759. Based on the optimal cut-off value, multivariate logistic regression indicates that low AGR can differentiate UC from non-UC (OR = 2.564, 95% CI = 1.433–4.587, p = 0.002) and CD from non-CD (OR = 3.732, 95% CI = 1.640–8.492, p = 0.001). Conclusion AGR may become a promising candidate to help clinicians differentiate IBD and evaluate IBD disease activity. Inflammation and nutritional status might be the future directions to explore its mechanism.

Risk Factors and the Role of the Albumin-to-Globulin Ratio in Predicting Recurrence Among Patients with Idiopathic Granulomatous Mastitis

“…AGR has been evaluated in many inflammatory, autoimmune, and malignant diseases and its prognostic role determined in numerous previous studies. [13][14][15][16][17][18][19]26 However, we encountered no studies evaluating the relationship between AGR and IGM. In the present study, we investigated the role of AGR in patients with IGM for the first time in the literature.…”

“…Previous studies have identified low AGR values as a poor prognostic factor in solid cancers such as those of the esophagus, stomach, and colon, and nasopharyngeal cancers. [14][15][16][17] In addition, AGR is an inflammation-based index that has been shown to be capable of predicting the severity of inflammatory bowel diseases, 18 predicting the risk of developing lupus nephritis in patients with systemic lupus erythematosus. 19 However, the association between AGR and IGM recurrence has never been studied so far.…”

Combination of albumin-to-globulin ratio and plasma fibrinogen is a sensitive tool for preoperative screening of infected nonunion in patients undergoing reoperation after open reduction and internal fixation: a retrospective study

“…Albumin and globulin, easily accessible and reliable biomarkers in the basic metabolic panel, have proven to be critical markers associated with inflammation and infection [ 34 , 35 ]. Albumin, a negative acute-phase reactant, is widely considered to be an inflammatory and nutritional biomarker in humans [ 36 ].…”

Combination of albumin-to-globulin ratio with plasma fibrinogen is a sensitive tool for preoperatively screening infected nonunion in patients undergoing reoperation after open reduction and internal fixation

“…Albumin and globulin, easily accessible and reliable biomarkers in the basic metabolic panel, have proven to be critical markers associated with in ammation and infection. 29,30 Albumin, a negative acute-phase reactant, is widely considered to be a biomarker of in ammatory and nutritional condition of the human body. 31 Hypoalbuminemia is correlated with malnutrition, hepatopathy, kidney disease, and all kinds of in ammation.…”