Alb/glob ratio
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The Role of Albumin to Globulin Ratio (AGR) in Clinical Prognosis
Introduction to Albumin to Globulin Ratio (AGR)
The albumin to globulin ratio (AGR) is a significant biomarker used in various medical conditions to assess the nutritional and inflammatory status of patients. It is calculated by dividing the serum albumin (ALB) level by the serum globulin (GLB) level. This ratio has been found to have prognostic value in several diseases, including heart failure, stroke, cancer, and infections.
AGR in Heart Failure Prognosis
In patients with heart failure (HF), the AGR has been shown to be a valuable predictor of overall survival (OS). A study involving 404 patients with HF demonstrated that a higher AGR was significantly associated with better OS. This suggests that monitoring AGR could help in predicting patient outcomes and tailoring treatment strategies accordingly 1.
AGR in Acute Ischemic Stroke
The prognostic value of AGR has also been explored in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis (IVT). Research indicates that an elevated AGR on day 7 post-IVT is associated with improved functional outcomes. This highlights the importance of dynamic monitoring of AGR in AIS patients to better predict recovery and guide therapeutic decisions 2.
AGR in Cancer Prognosis
Glioblastoma
In glioblastoma (GBM) patients, both preoperative serum albumin levels and AGR have been identified as significant predictors of progression-free survival (PFS) and overall survival (OS). Higher AGR values were associated with better prognosis, emphasizing the role of AGR as a non-invasive biomarker in the management of GBM 5.
Gastric Cancer
Similarly, in gastric cancer patients, a low preoperative globulin level and a high AGR were linked to favorable survival outcomes. This suggests that AGR can serve as a valuable marker for predicting prognosis and potentially guiding preoperative and postoperative care in gastric cancer 7.
AGR in Veterinary Medicine
The utility of AGR extends beyond human medicine. In veterinary practice, particularly in dogs with naturally occurring parvovirus infection (PVI), pretreatment AGR has been found to be significantly higher in infected dogs compared to healthy controls. This indicates that AGR could be a useful prognostic marker in veterinary settings as well 6.
Methods of Measuring AGR
AGR can be measured using different methods, including electrophoresis and chemical assays. Studies have shown that the values obtained from these methods correlate well, making both approaches reliable for clinical use. However, it is important to choose the appropriate method based on the specific clinical context and available resources 3.
Conclusion
The albumin to globulin ratio (AGR) is a crucial biomarker with significant prognostic value in various medical conditions, including heart failure, acute ischemic stroke, glioblastoma, and gastric cancer. Its utility in both human and veterinary medicine underscores its importance as a non-invasive, cost-effective tool for predicting patient outcomes and guiding treatment strategies. Regular monitoring of AGR can provide valuable insights into the patient's nutritional and inflammatory status, aiding in better clinical decision-making.
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Most relevant research papers on this topic
Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China
Higher albumin to globulin ratio is associated with favourable overall survival in patients with heart failure.
Observational Study
Rigorous JournalElevated Albumin to Globulin Ratio on Day 7 is Associated with Improved Function Outcomes in Acute Ischemic Stroke Patients with Intravenous Thrombolysis
A/G ratio is an important prognostic indicator for acute ischemic stroke outcomes and warrants dynamic monitoring.
Observational StudyRigorous JournalComparative study on the serum albumin and the ratio of albumin and globulin determined by electrophoresis and chemical assay
Electrophoresis can replace chemical assay for determining serum albumin and albumin/globulin ratios, with no significant difference in results.
Use of the Vettest 8008 and refractometry for determination of total protein, albumin, and globulin concentrations in feline effusions.
The refractometer is an acceptable method for determining total protein concentration in feline effusions, while the Vettest 8008 is also acceptable for TP and ALB concentrations, but A/G ratios are inacceptable.
Observational StudySerum albumin levels and serum albumin-globulin ratio are associated with poor prognosis in glioblastoma
Serum albumin levels and albumin-globulin ratio are significant predictors of prognosis in glioblastoma patients, with postoperative adjuvant treatment also being an independent predictor.
Observational StudyEvaluation of Pretreatment Serum Albumin-to-Globulin Ratio in Dogs with Naturally Occurring Parvovirus Infection
Pretreatment serum GLB levels and the albumin-to-globulin ratio could be new prognostic marker candidates in dogs with naturally occurring parvovirus infection.
RCT
Animal StudyLow pretreatment serum globulin may predict favorable prognosis for gastric cancer patients
Low preoperative serum globulin levels may predict a favorable prognosis for gastric cancer patients, while low albumin levels are associated with a worse prognosis.
Observational StudyVariation of plasma protein parameters in four free-ranging reindeer herds and in captive reindeer under defined feeding conditions.
Plasma total protein and albumin levels, and to a lesser extent globulin and A/G ratio, may serve as nutritional biomarkers for reindeer, with season and year being the main factors influencing blood constituents.
Observational StudyGelation behaviors of denaturated pea albumin and globulin fractions during transglutaminase treatment
Denaturation of pea proteins can enhance gel formation properties with transglutaminase treatment, but caution is needed due to protein composition and conformation.
A comparative study of the structural and functional properties of isolated hemp seed (Cannabis sativa L.) albumin and globulin fractions
ALB has a more flexible structure and higher protein solubility than GLB, making it a potential candidate for use in pharmaceutical formulations.
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