The major proteins seen in the serum are albumin and globulin-the latter being primarily alpha 1 and alpha 2 globulin, beta globulin and gamma globulin. Albumin accounts for more than 50% of the total serum proteins. The albumin to globulin (A/G) ratio has been used as an index of disease state, however, it is not a specific marker for disease because it does not indicate which specific proteins are altered. The normal A/G ratio is 0.8-2.0. The albumin/globulin ratio is used to try to identify causes of change in total serum protein. It will go out of the normal range if one component increases or decreases relative to the other. Hence it is important to look at changes in the individual components (albumin and globulins) as well as the ratio.
A low albumin/globulin ratio may reflect overproduction of globulins, such as seen in multiple myeloma or autoimmune diseases, or underproduction of albumin, such as may occur with cirrhosis, or selective loss of albumin from the circulation, as may occur with kidney disease (nephrotic syndrome).
A high albumin/globulin ratio suggests underproduction of immunoglobulins as may be seen in some genetic deficiencies and in some leukemias.
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