A serum albumin and globulin (A/G) ratio test is a kind of blood work that determines the ratio of albumin to globulin, the two key proteins in the blood. Generally, the A/G ratio test is performed as part of a routine protein blood work, which is used to assess a person's health status including nutritional deficiency and immune function.
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This blood work is also used to screen and monitor several other medical conditions including kidney disease, chronic infections, and cancers to mention a few.

Read this article to learn about the purposes of an A/G ratio blood test, the procedure and how results are interpreted.

Purpose

The albumin/globulin (A/G) ratio test is done to measure the total amount of protein in the blood. Two major types of protein in the blood:

Albumin: It helps to maintain blood from leaking out of blood vessels. It also carries hormones, medicines, vitamins, and other vital substances throughout the system. Albumin is made in the liver.

Globulins: They help combat infection and carry nutrients throughout the system. Some globulins are made by the liver and others by the immune system.

This test also compares the amount of albumin in blood to the amount of globulin called the albumin/globulin (A/G) ratio. If the results are abnormal, it can indicate a severe health condition.

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Why Do I Need The Test?

You may get this test done as the routine process of a complete metabolic panel that is included in a regular health check-up.  You may also require this test if you exhibit symptoms that indicate abnormal protein levels, these include:

  • Swelling in the lower extremities and/or abdomen
  • Extreme Fatigue
  • Sudden weight loss
  • Poor appetite
  • Nausea
  • Vomiting
  • Jaundice
  • Blood in the urine

Also Read: 24-Hour Urine Protein Test: What Is It, Purpose, Benefits And Results

What Happens During The Test?

A phlebotomist or lab technician will collect the blood sample from a vein in the arm, with the help of a small needle into a test tube or vial. You may feel a mild sting when the needle is inserted, and it usually takes less than 5 minutes.

Results

The normal range for the albumin/globulin ratio is 1 to 2. Albumin is little more than globulin in serum protein. An imbalance in protein production within the human body can result in either an elevated or reduced A/G ratio.

Low A/G Ratio

A low A/G ratio is usually a sign that albumin levels are very low (hypoalbuminemia), or globulin levels are too high. Conditions associated with a low A/G ratio include:

  • Kidney disease
  • Liver disease
  • Impaired liver function
  • HIV, tuberculosis, and hepatitis
  • Malnutrition
  • Pancreatitis
  • Autoimmune diseases like rheumatoid arthritis)
  • Certain cancers like liver cancer, blood cancer, colorectal cancer, pancreatic cancer and lung cancer
  • Type 2 diabetes (insulin deficiency)

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High A/G ratio

High albumin concentration may be due to the overproduction of albumin by the liver or when serum levels are very low. It can also be due to severe dehydration, diarrhoea or during pregnancy.

Healthy kidneys don’t let albumin pass from the blood into urine and high albumin in the urine(albuminuria) is an indicator of kidney disease. A high A/G result may also indicate low levels of globulin, that are seen in people with antibody deficiencies (weakened immune system).

Low globulin levels can also develop due to malnutrition.

Apart from assessing overall protein levels, your doctor might also request an individual blood test for albumin and globulins. The measurement of globulins involves a serum electrophoresis test, which evaluates the quantities of four distinct categories of globulins. Results may show the following:

Low albumin levels related to:

  • Liver disease - cirrhosis
  • Kidney disease
  • Malnutrition
  • Thyroid disease

High albumin levels related to:

Low globulin levels related to:

  • Liver disease
  • Kidney disease

High globulin levels related to:

  • Certain types of blood cancers, such as multiple myeloma, Hodgkin's disease, or leukaemia
  • Haemolytic anaemia
  • An autoimmune disorder like lupus or rheumatoid arthritis
  • Tuberculosis