Skip to content
2000
Volume 22, Issue 1
  • ISSN: 1567-2026
  • E-ISSN: 1875-5739

Abstract

Background

The relationships between serum albumin, albumin-globulin (A/G) ratio, globulin and atherosclerosis in acute ischemic stroke (AIS) remain uncertain. We investigated the associations between serum albumin, A/G ratio, globulin levels and carotid atherosclerosis in patients with AIS.

Methods

A total of 1,339 AIS patients were enrolled. Admission A/G ratio was divided into quartiles, and serum albumin and globulin levels were also categorized. Carotid atherosclerosis was detected through the assessment of common carotid artery intima-media thickness (cIMT), and abnormal cIMT was characterized by mean and maximum cIMT values of ≥1 mm. We evaluated the relationships between A/G ratio, albumin, globulin and abnormal cIMT, using multivariable logistic regression models.

Results

In the multivariable-adjusted analysis, the highest A/G ratio quartile (Q4) was linked to a 59% decreased risk of abnormal mean cIMT (OR 0.41; 95% CI 0.29-0.60) and a 58% decreased risk of abnormal maximum cIMT (OR 0.42; 95% CI 0.30-0.60) when compared to the lowest quartile (Q1), respectively. Moreover, decreased albumin and elevated globulin levels were also associated with abnormal mean cIMT and maximum cIMT. In addition, the A/G ratio provided supplementary predictive capability beyond the already established risk factors, and the C-statistic of the A/G ratio for abnormal cIMT is larger than globulin ( <0.01).

Conclusion

Decreased serum A/G ratio, albumin and elevated serum globulin were independently associated with abnormal cIMT in AIS patients. Moreover, the A/G ratio appeared to be a better predictor of abnormal cIMT.

Loading

Article metrics loading...

/content/journals/cnr/10.2174/0115672026276085231122053601
2023-12-01
2025-10-09
Loading full text...

Full text loading...

References

  1. LorenzM.W. MarkusH.S. BotsM.L. RosvallM. SitzerM. Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis.Circulation2007115445946710.1161/CIRCULATIONAHA.106.628875 17242284
    [Google Scholar]
  2. O’LearyD.H. PolakJ.F. KronmalR.A. ManolioT.A. BurkeG.L. WolfsonS.K.Jr Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults.N. Engl. J. Med.19993401142210.1056/NEJM199901073400103 9878640
    [Google Scholar]
  3. LorenzM.W. von KeglerS. SteinmetzH. MarkusH.S. SitzerM. Carotid intima-media thickening indicates a higher vascular risk across a wide age range: prospective data from the Carotid Atherosclerosis Progression Study (CAPS).Stroke2006371879210.1161/01.STR.0000196964.24024.ea 16339465
    [Google Scholar]
  4. LibbyP. RidkerP.M. MaseriA. Inflammation and atherosclerosis.Circulation200210591135114310.1161/hc0902.104353 11877368
    [Google Scholar]
  5. RossR. Atherosclerosis--an inflammatory disease.N. Engl. J. Med.1999340211512610.1056/NEJM199901143400207 9887164
    [Google Scholar]
  6. SchillingerM. ExnerM. MlekuschW. Inflammation and carotid artery-risk for atherosclerosis study (ICARAS).Circulation2005111172203220910.1161/01.CIR.0000163569.97918.C0 15851593
    [Google Scholar]
  7. Fernández-FrieraL. FusterV. López-MelgarB. Vascular inflammation in subclinical atherosclerosis detected by hybrid PET/MRI.J. Am. Coll. Cardiol.201973121371138210.1016/j.jacc.2018.12.075 30922468
    [Google Scholar]
  8. WangT.J. NamB.H. WilsonP.W.F. Association of C-reactive protein with carotid atherosclerosis in men and women: The Framingham Heart Study.Arterioscler. Thromb. Vasc. Biol.200222101662166710.1161/01.ATV.0000034543.78801.69 12377746
    [Google Scholar]
  9. EltoftA. ArntzenK.A. WilsgaardT. MathiesenE.B. JohnsenS.H. Interleukin-6 is an independent predictor of progressive atherosclerosis in the carotid artery: The Tromsø Study.Atherosclerosis20182711810.1016/j.atherosclerosis.2018.02.005 29453087
    [Google Scholar]
  10. KofoedS. WittrupH.H. SillesenH. NordestgaardB.G. Fibrinogen predicts ischaemic stroke and advanced atherosclerosis but not echolucent, rupture-prone carotid plaques The Copenhagen City Heart Study.Eur. Heart J.200324656757610.1016/S0195‑668X(02)00467‑0 12643890
    [Google Scholar]
  11. RonitA. Kirkegaard-KlitboD.M. DohlmannT.L. Plasma albumin and incident cardiovascular disease.Arterioscler. Thromb. Vasc. Biol.202040247348210.1161/ATVBAHA.119.313681 31852221
    [Google Scholar]
  12. ArquesS. Human serum albumin in cardiovascular diseases.Eur. J. Intern. Med.20185281210.1016/j.ejim.2018.04.014 29680174
    [Google Scholar]
  13. MukaiH. VillafuerteH. QureshiA.R. LindholmB. StenvinkelP. Serum albumin, inflammation, and nutrition in end‐stage renal disease: C‐reactive protein is needed for optimal assessment.Semin. Dial.201831543543910.1111/sdi.12731 29926516
    [Google Scholar]
  14. IshizakaN. IshizakaY. NagaiR. TodaE.I. HashimotoH. YamakadoM. Association between serum albumin, carotid atherosclerosis, and metabolic syndrome in Japanese individuals.Atherosclerosis2007193237337910.1016/j.atherosclerosis.2006.06.031 16904116
    [Google Scholar]
  15. WangY.H. ChenS.Y. WangT.D. HwangB.S. HuangT.S. SuT.C. The relationships among serum glucose, albumin concentrations and carotid atherosclerosis in men with spinal cord injury.Atherosclerosis2009206252853410.1016/j.atherosclerosis.2009.02.035 19349048
    [Google Scholar]
  16. DjousséL. RothmanK.J. CupplesL.A. ArnettD.K. EllisonR.C. Relation between serum albumin and carotid atherosclerosis: The NHLBI Family Heart Study.Stroke2003341535710.1161/01.STR.0000048675.97975.84 12511750
    [Google Scholar]
  17. FolsomA.R. MaJ. EckfeldtJ.H. NietoF.J. MetcalfP.A. BarnesR.W. Low serum albumin ☆ Association with diabetes mellitus and other cardiovascular risk factors but not with prevalent cardiovascular disease or carotid artery intima-media thickness.Ann. Epidemiol.19955318619110.1016/1047‑2797(94)00105‑3 7606307
    [Google Scholar]
  18. HillL.A. BodnarT.S. WeinbergJ. HammondG.L. Corticosteroid-binding globulin is a biomarker of inflammation onset and severity in female rats.J. Endocrinol.2016230221522510.1530/JOE‑16‑0047 27418032
    [Google Scholar]
  19. ShiraishiK. FurukawaS. YagiS. Serum globulin is associated with endoscopic findings and mucosal healing in japanese patients with ulcerative colitis.Dig. Dis. Sci.202267123324010.1007/s10620‑021‑06834‑5 33537920
    [Google Scholar]
  20. NiedzielaJ.T. HudzikB. Szygula-JurkiewiczB. Albumin-to-globulin ratio as an independent predictor of mortality in chronic heart failure.Biomarkers Med.201812774975710.2217/bmm‑2017‑0378 29865856
    [Google Scholar]
  21. AzabB. BibawyJ. HarrisK. Value of albumin-globulin ratio as a predictor of all-cause mortality after non-ST elevation myocardial infarction.Angiology201364213714510.1177/0003319712436577 22345150
    [Google Scholar]
  22. YangD. ShenJ. HuangH. Elevated albumin to globulin ratio on day 7 is associated with improved function outcomes in acute ischemic stroke patients with intravenous thrombolysis.J. Inflamm. Res.2022152695270510.2147/JIR.S347026 35505797
    [Google Scholar]
  23. MiaoM. ZhouG. BaoA. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke.Cardiovasc. Diabetol.20222114310.1186/s12933‑022‑01472‑1 35303881
    [Google Scholar]
  24. ChamblessL.E. HeissG. FolsomA.R. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993.Am. J. Epidemiol.1997146648349410.1093/oxfordjournals.aje.a009302 9290509
    [Google Scholar]
  25. NaqviT.Z. LeeM.S. Carotid intima-media thickness and plaque in cardiovascular risk assessment.JACC Cardiovasc. Imaging20147101025103810.1016/j.jcmg.2013.11.014 25051948
    [Google Scholar]
  26. MukaiN. NinomiyaT. HataJ. Association of hemoglobin A1c and glycated albumin with carotid atherosclerosis in community-dwelling Japanese subjects: the Hisayama Study.Cardiovasc. Diabetol.20151418410.1186/s12933‑015‑0247‑7 26099223
    [Google Scholar]
  27. SongS.O. KimK.J. LeeB.W. KangE.S. ChaB.S. LeeH.C. Serum glycated albumin predicts the progression of carotid arterial atherosclerosis.Atherosclerosis2012225245045510.1016/j.atherosclerosis.2012.09.005 23040867
    [Google Scholar]
  28. FurusyoN. KogaT. AiM. Plasma glycated albumin level and atherosclerosis: Results from the Kyushu and Okinawa Population Study (KOPS).Int. J. Cardiol.201316752066207210.1016/j.ijcard.2012.05.045 22658569
    [Google Scholar]
  29. GabayC. KushnerI. Acute-phase proteins and other systemic responses to inflammation.N. Engl. J. Med.1999340644845410.1056/NEJM199902113400607 9971870
    [Google Scholar]
  30. FulksM. StoutR.L. DolanV.F. Serum globulin predicts all-cause mortality for life insurance applicants.J. Insur. Med.20144429398[PMID: 25816467
    [Google Scholar]
  31. XingY. GuoZ.N. YanS. JinH. WangS. YangY. Increased globulin and its association with hemorrhagic transformation in patients receiving intra-arterial thrombolysis therapy.Neurosci. Bull.201430346947610.1007/s12264‑013‑1440‑x 24871645
    [Google Scholar]
  32. LvG. AnL. SunX. HuY. SunD. Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: A meta-analysis.Clin. Chim. Acta2018476819110.1016/j.cca.2017.11.019 29170102
    [Google Scholar]
  33. MaedaS. TakeyaY. OguroR. Serum albumin/globulin ratio is associated with cognitive function in community‐dwelling older people: The Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study.Geriatr. Gerontol. Int.2019191096797110.1111/ggi.13751 31461209
    [Google Scholar]
  34. ChenY. ChenY. ZhaoL. Albumin/globulin ratio as yin–yang in rheumatoid arthritis and its correlation to inflamm-aging cytokines.J. Inflamm. Res.2021145501551110.2147/JIR.S335671 34737599
    [Google Scholar]
/content/journals/cnr/10.2174/0115672026276085231122053601
Loading
/content/journals/cnr/10.2174/0115672026276085231122053601
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test