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Frontiers in Public Health 2023Cognitive impairment is on the rise around the world, with profound economic and social consequences. Serum globulin, a marker of liver function, may also play a role in...
BACKGROUND AND AIMS
Cognitive impairment is on the rise around the world, with profound economic and social consequences. Serum globulin, a marker of liver function, may also play a role in cognitive function. Unfortunately, no consistent conclusion exists regarding the association between serum globulin and cognitive function.
METHODS
Data from the 2011 to 2014 National Health and Nutrition Examination Survey were used to assess the association between serum globulin and cognitive impairment. Cognitive function was assessed by three tests: Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency (AF), and Digit Symbol Substitution Test (DSST). Furthermore, the breakthrough point of cognitive impairment correlated with CERAD < 5, AF < 14, and DSST < 34. A weighted multiple logistics regression model was used to verify the association between serum globulin and cognitive impairment. Generalized additive models (GAMs) and a smooth curve fit (penalty spline method) were used to determine a non-linear relationship between serum globulin and cognitive impairment. Finally, subgroup analysis and interaction tests were conducted to further verify the association between serum globulin and cognitive impairment.
RESULTS
Data from 2,768 participants aged ≥60 (in accordance with the study design) were collected for the final analysis. Data suggested that serum globulin levels were associated with an elevated cognitive impairment based on the AF [full adjustment, OR = 1.05, 95% 1.01-1.08] and DSST [full adjustment, OR = 1.06, 95% 1.02-1.10] tests. Eventually, the GAM and smooth curve fit model was conducted to confirm that the association between serum globulin and cognitive impairment was non-linear. Moreover, the inflection point was 27 g/L serum globulin based on the CERAD test and 35 g/L serum globulin based on the AF test. Finally, the interaction term between serum globulin and cognitive impairment based on the AF test indicated no significant interactions among all variables (all for interaction >0.05).
CONCLUSION
The association between serum globulin levels and cognitive impairment is non-linear. A threshold effect exists between serum globulin and cognitive impairment. Large-scale prospective clinical trials are needed to validate our findings.
Topics: Animals; Nutrition Surveys; Prospective Studies; Serum Globulins; Cognitive Dysfunction; Cognition; Alzheimer Disease
PubMed: 37670828
DOI: 10.3389/fpubh.2023.1193993 -
Asian Pacific Journal of Cancer... Feb 2021Serum protein concentrations are diagnostically and prognostically valuable in cancer and other diseases, but their measurement via blood test is uncomfortable,...
OBJECTIVE
Serum protein concentrations are diagnostically and prognostically valuable in cancer and other diseases, but their measurement via blood test is uncomfortable, inconvenient, and costly. This study investigates the possibility of predicting albumin, globulin, and albumin-globulin ratio from easily accessible physical characteristics (height, weight, Body Mass Index, age, gender) and vital signs (systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, pulse) using advanced machine learning techniques.
METHODS
We obtained albumin concentration, globulin concentration, albumin-globulin ratio and predictor information (physical characteristics, vital signs) from physical exam records of 46,951 healthy adult participants in Hangzhou, China. We trained a computational model to predict each serum protein concentration from the predictors and then evaluated the predictive accuracy of each model on an independent portion of the dataset that was not used in model training. We also determined the relative importance of each feature within the model.
RESULTS
Prediction accuracies were r=0.540 (95% CI: 0.539-0.540; Pearson r) for albumin, r=0.250 (95% CI: 0.249-0.251) for globulin, and r=0.373 (95% CI: 0.372-0.374) for albumin-globulin ratio. The most important predictive features were age (100% ± 0.0%; mean ± 95% CI of normalized importance), gender (34.4% ± 0.7%), pulse (25.6% ± 1.3%) and Body Mass Index (24.4% ± 2.3%) for albumin, pulse (83.7% ± 3.8%) for globulin, and age (99.2% ± 1.0%), gender (59.2% ± 1.7%), Body Mass Index (46.1% ± 4.2%) and height (40.0% ± 3.8%) for albumin-globulin ratio.
CONCLUSIONS
Our models predicted serum protein concentrations with appreciable accuracy showing the promise of this approach. Such models could serve to augment existing tools for identifying "at-risk" individuals for follow-up with a blood test.
Topics: Adult; Age Factors; Body Height; Body Mass Index; Body Weight; China; Female; Humans; Machine Learning; Male; Middle Aged; Predictive Value of Tests; Serum Albumin; Serum Globulins; Sex Factors; Vital Signs
PubMed: 33639645
DOI: 10.31557/APJCP.2021.22.2.333 -
British Medical Journal Jun 1956
Topics: Globulins; Serum Globulins; Waldenstrom Macroglobulinemia
PubMed: 13316192
DOI: No ID Found -
Nephrology, Dialysis, Transplantation :... Sep 2022Serum globulin is a major component of total protein and can be elevated in inflammatory disease states. While inflammation is common in hemodialysis patients and...
BACKGROUND
Serum globulin is a major component of total protein and can be elevated in inflammatory disease states. While inflammation is common in hemodialysis patients and associated with mortality and morbidity, the association between serum globulin and mortality has never been examined in hemodialysis patients.
METHODS
In a retrospective cohort of 104 164 incident hemodialysis patients treated by a large dialysis organization from 2007 to 2011, we explored the association between baseline serum globulin, albumin: globulin (A:G) ratio and serum protein levels and all-cause, cardiovascular and infection-related mortality with adjustments for demographic variables and laboratory markers of malnutrition and inflammation using Cox proportional hazards models.
RESULTS
Patients with a globulin concentration >3.8 g/dL had a higher all-cause and infection-related mortality risk {hazard ratio [HR] 1.11 [95% confidence interval (CI) 1.06-1.16] and HR 1.28 [95% CI 1.09-1.51], respectively} in the fully adjusted model when compared with the reference group of 3.0- <3.2 g/dL. In addition, patients with an A:G ratio <0.75 had a 45% higher all-cause mortality hazard [HR 1.45 (95% CI 1.38-1.52)] and patients with total serum protein <5.5 g/dL had a 34% higher risk of death [1.34 (95% CI 1.27-1.42)] when compared with the reference (A:G ratio 1.05- <1.15 and total serum protein 6.5- <7 g/dL).
CONCLUSIONS
Among incident hemodialysis patients, a higher globulin level was associated with a higher mortality risk independent of other markers of malnutrition and inflammation, including albumin. A lower A:G ratio and serum protein was also associated with a higher mortality hazard. The mechanisms that contribute to elevated serum globulin should be further explored.
Topics: Albumins; Biomarkers; Humans; Inflammation; Kidney Failure, Chronic; Malnutrition; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Serum Globulins
PubMed: 34617572
DOI: 10.1093/ndt/gfab292 -
Journal of Orthopaedic Surgery and... Oct 2020Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire...
BACKGROUND
Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA).
METHODS
A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve.
RESULTS
Higher globulin levels (odds ratio [OR], 1.239; P < 0.001) and lower A/G ratio (OR, 0.007; P < 0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%).
CONCLUSIONS
Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.
Topics: Aged; Arthroplasty, Replacement; Biomarkers; Female; Humans; Logistic Models; Male; Middle Aged; Prosthesis-Related Infections; ROC Curve; Reoperation; Retrospective Studies; Serum Albumin; Serum Globulins
PubMed: 33028348
DOI: 10.1186/s13018-020-01959-1 -
Journal of Orthopaedic Surgery and... Jan 2022Periprosthetic joint infection (PJI) is one of the most challenging complications of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated...
BACKGROUND
Periprosthetic joint infection (PJI) is one of the most challenging complications of total joint arthroplasty (TJI). An early and accurate diagnosis of PJI is associated with better treatment outcomes. However, whether the platelet-related markers and globulin-related markers can be used to assist the diagnosis of PJI remains elusive.
METHODS
A total of 206 patients who underwent revision hip or knee arthroplasty in our institution were divided into two groups: 79 patients in PJI group and 127 patients in aseptic failure group. The levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet-related markers including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and PLT to MPV ratio (PMR) and globulin-related markers such as globulin (GLB), albumin to globulin ratio (AGR) and PLT to AGR ratio were compared. The diagnostic value was measured using area under the curve (AUC) after constructing receiver operating characteristic (ROC) curves. The potential of each marker for determining the timing of second-staged reimplantation was also evaluated.
RESULTS
Significantly increased levels of ESR, CRP, PLT, PCT, PMR, GLB and PLT to AGR ratio were identified in PJI group, while decreased levels of MPV and AGR were also found. The diagnostic values of all platelet-related markers and GLB were considered as fair, and good diagnostic values of AGR and PLT to AGR ratio were found, which were comparable to those of ESR and CRP. The levels of GLB and AGR can also be used to predict negative culture result and the timing of second-stage reimplantation.
CONCLUSIONS
Globulin and albumin to globulin ratio were found to have good diagnostic values for PJI, and they can precisely predict the culture results and persistent infection.
Topics: Aged; Aged, 80 and over; Albumins; Arthritis, Infectious; Arthroplasty, Replacement, Hip; Biomarkers; Blood Sedimentation; C-Reactive Protein; Female; Globulins; Humans; Male; Middle Aged; Persistent Infection; Prosthesis-Related Infections; Replantation; Retrospective Studies; Sensitivity and Specificity; Serum Albumin; Serum Globulins
PubMed: 34991649
DOI: 10.1186/s13018-021-02899-0 -
Frontiers in Immunology 2022Hypogammaglobulinemia is a condition that requires prompt diagnosis and treatment. Unfortunately, serum immunoglobulin (Ig) measurements are not widely accessible in...
Hypogammaglobulinemia is a condition that requires prompt diagnosis and treatment. Unfortunately, serum immunoglobulin (Ig) measurements are not widely accessible in numerous developing countries. Serum globulin is potentially the best candidate for screening of low IgG level (IgGLo) due to its high availability, low cost, and rapid turnover time. However, multiple factors may influence the probability of prediction. Our study aimed to establish a simple prediction model using serum globulin to predict the likelihood of IgGLo in children. For retrospective data of patients who were suspected of having IgGLo, both serum IgG and globulin were simultaneously collected and measured. Potential factors interfering with serum globulin and IgG levels were investigated for their impact using bivariate binary logistic regression. A multivariate binary logistic regression was used to generate a formula and score to predict IgGLo. We obtained 953 samples from 143 pediatric patients. A strong positive correlation between serum globulin and IgG levels was observed (r=0.83, p < 0.001). A screening test model using serum globulin and illness status was constructed to predict IgGLo. The formula for predicting IgGLo was generated as follows; Predicted score = (2 x globulin (g/dl)) - illness condition score (well=0, sick=1). When the score was <4, the patient has the probability of having IgGLo with a sensitivity of 0.78 (0.71, 0.84), a specificity of 0.71 (0.68, 0.74), PPV of 0.34 (0.29, 0.40) and NPV of 0.94 (0.92, 0.96). This formula will be useful as rapid and inexpensive screening tool for early IgGLo detection, particularly in countries/locations where serum IgG measurement is inaccessible.
Topics: Agammaglobulinemia; Child; Humans; Immunoglobulin G; Mass Screening; Retrospective Studies; Serum Globulins
PubMed: 35265080
DOI: 10.3389/fimmu.2022.825867 -
Frontiers in Public Health 2024Inflammation and liver function are associated with cognitive decline and dementia. Little is known about the serum albumin-to-globulin ratio on cognitive function.
Non-linear relationship of serum albumin-to-globulin ratio and cognitive function in American older people: a cross-sectional national health and nutrition examination survey 2011-2014 (NHANES) study.
BACKGROUND
Inflammation and liver function are associated with cognitive decline and dementia. Little is known about the serum albumin-to-globulin ratio on cognitive function.
OBJECTIVE
The objective of this study was to investigate the association between albumin-to-globulin ratio and cognitive function among the American older people.
METHODS
The public data available on the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014 was used for this cross-sectional study. Participants aged ≥60 years completed the cognitive function assessments, including word learning and recall modules from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the animal fluency (AF) test, and the digit symbol substitution test (DSST). A composite cognition score was calculated to evaluate global cognition. The univariate and multivariate linear regression analysis, curve fitting, a threshold effect, along with a subgroup analysis and interaction tests were conducted.
RESULTS
Serum albumin-to-globulin ratio (per 0.1 unit) was positively associated DSST score (β = 0.36, 95% CI: 0.21, 0.51), AF score (β = 0.1, 95% CI: 0.04, 0.16) and global cognition score (β = 0.05, 95% CI: 0.02, 0.07), after being fully adjusted, while albumin-to-globulin ratio was not related to CERAD score (β = 0.05, 95% CI: -0.02, 0.12). A non-linear was observed in the dose-response relationship between albumin-to-globulin ratio and global cognition ( for non-linearity < 0.001). The subgroup analysis was overall stable, yet the interaction test was significant for age on global cognition ( for interaction = 0.036).
CONCLUSION
The findings of this cross-sectional study suggested a positive and non-linear association between albumin-to-globulin ratio and cognitive function in the American older people. Maintaining albumin-to-globulin ratio with an appropriate range may be one of the therapeutic strategies to limit the progression of cognitive decline for the older people.
Topics: Humans; Cross-Sectional Studies; Male; Female; Nutrition Surveys; Aged; Cognition; United States; Middle Aged; Serum Albumin; Cognitive Dysfunction; Aged, 80 and over; Serum Globulins; Globulins
PubMed: 38737864
DOI: 10.3389/fpubh.2024.1375379 -
Scientific Reports Jan 2023Serum globulin, which is composed mainly of immunoglobulins and acute phase proteins, can be considered as reflecting the inflammatory state. We conducted the present...
Serum globulin, which is composed mainly of immunoglobulins and acute phase proteins, can be considered as reflecting the inflammatory state. We conducted the present study to investigate the role of globulin in mortality risk in patients undergoing peritoneal dialysis (PD). The study participants were categorized by the median globulin value (2.8 g/dL) as the high globulin group (≥ 2.8 g/dL), and low globulin group (< 2.8 g/dL). Serum globulin is calculated by the equation: (serum total protein-serum albumin). The area under the curve (AUC) by the receiver operating characteristics curve analysis was calculated to compare the mortality prediction capacity of globulin with that of ferritin, and WBC counts. Among the 554 patients, 265 (47.83%) were men, the mean age was 52.91 ± 15.54 years and the body mass index was 23.44 ± 3.88 kg/m. Multivariate Cox models showed the high globulin group had higher mortality risks of all-cause and cardiovascular disease (CVD), compared with the low globulin group with adjusted HRs of 2.06 (95% CI 1.39-3.05) and 1.94 (95% CI 1.18-3.16), respectively. The AUC of univariate and multivariate models for all-cause mortality resulted in higher AUC values for globulin than for ferritin and white blood cell (WBC) counts. In patients undergoing PD, the serum globulin can serve as a novel and independent determinant of predicting overall and CVD- associated mortality.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Cardiovascular Diseases; Ferritins; Peritoneal Dialysis; Serum Globulins
PubMed: 36670150
DOI: 10.1038/s41598-023-27688-z -
The Journal of Experimental Medicine May 1966The serological characteristics of gammaA-anti-A and anti-B were studied using, as a source, either colostrum, or fractions relatively rich in gammaA obtained from...
The serological characteristics of gammaA-anti-A and anti-B were studied using, as a source, either colostrum, or fractions relatively rich in gammaA obtained from selected potent antisera. gammaA-anti-A and anti-B were never hemolytic nor did they sensitize red cells to agglutination by anticomplement globulin sera. gammaA-anti-A, like gammaG-anti-A and unlike gammaM-anti-A was unaffected by heating at 56 degrees C for 3 hr. On the other hand in the following three characteristics the behavior of gammaA fell between that of gammaG- or gammaM-anti-A: sensitivity to inactivation by 2-mercaptoethanol, ease of neutralization by A substance and degree of enhancement of agglutination in a medium of serum rather than saline. The agglutination produced by gammaA-anti-A was regularly enhanced by addition of anti-gammaA-globulin serum. In searching for gammaA-blood group antibodies of other specificities the following sera were tested: anti-D (32 examples); anti-c (2 examples); anti-Le(a) or -Le(b) (3 examples); anti-K (3 examples); anti-Fy(a) (3 examples), and anti-Jk(a) (3 examples). Only 3 sera, all containing anti-D, sensitized red cells to agglutination by anti-gammaA. There were no discrepancies between results obtained with four different anti-gammaA-globulin sera. Approximately half the sera were fractionated on DEAE-cellulose, and the fractions rich in gammaA tested for their ability to sensitize red cells to agglutination by anti-gammaA; no additional examples of gammaA-antibodies were detected. One of the three examples of gammaA-anti-D appeared in the serum of a woman during the course of deliberate reimmunization. gammaA-anti-D appeared only after three intravenous injections of red cells although the gammaG-anti-D titer rose considerably after a single injection. 3 yr after a fourth injection of Rh-positive cells gammaA-anti-D, as well as gammaG-anti-D, was still present in the serum.
Topics: Blood Group Antigens; Humans; Isoantibodies; gamma-Globulins
PubMed: 4161013
DOI: 10.1084/jem.123.5.951