Table of ContentsView AllTable of ContentsHow It Is CalculatedWhy You Might Need an A/G TestLow A/G RatioHigh A/G RatioDiagnosis
Table of ContentsView All
View All
Table of Contents
How It Is Calculated
Why You Might Need an A/G Test
Low A/G Ratio
High A/G Ratio
Diagnosis
The A/G ratio is a blood test that measures the amount ofalbuminandglobulinproteins in your blood. A high A/G ratio may indicate kidney disease, an antibody deficiency, or severe dehydration. A low A/G ratio can also indicate kidney disease, liver disease, chronic infections like HIV, autoimmune diseases likelupus, and certain cancers.
The A/G ratio may be performed as part of a routine blood test called the comprehensive metabolic panel (CMP) or ordered if you have certain unusual symptoms likehematuria(blood in the urine) orjaundice(yellowing of the eyes or skin).
Maskot / Getty Images
What A/G Ratio Measures
The A/G ratio describes the amount of albumin compared to the amount of globulin in your blood. Both are called serum proteins. They have different purposes in the human body, as follows:
Under normal circumstances, there is slightly more albumin in your blood than globulin.
Normal A/G Ratio Range
The A/G test is often a part of the comprehensive metabolic panel, a routine test your healthcare provider may order. You also may need an A/G test if your healthcare provider is concerned aboutliver diseaseorsigns of chronic kidney disease, which can include:
Let your healthcare provider know if you experience symptoms that might suggest an A/G test is needed.
What Does a Low A/G Ratio Mean?
When your body is functioning normally, the proportion of albumin to globulin will remain relatively consistent. When the proportion changes and the A/G ratio is low, it may be a sign of an infection, disease, or nutritional deficiency.
Your A/G ratio may become low for three reasons:
In contrast, high globulin levels are typically a sign ofinflammationor the activation of theimmune systemto fight an infection or disease.
To this end, the possible causes of a low A/G ratio include:
A low A/G ratio does not cause symptoms other than those related to the underlying cause.
What Does a High A/G Ratio Mean?
A high A/G ratio is far less common than a low A/G ratio and may occur when:
Globulin levels can drop when your body does not produce enough or an excessive amount is eliminated through the kidneys when you urinate.In contrast, the only situation in which albumin can abnormally increase is with severedehydration.
To this end, possible causes of a high A/G ratio include:
A high A/G ratio does not cause a set group of symptoms. In many cases, there may be no symptoms. However, people with low immunoglobulins are vulnerable to recurrent respiratory infections likepneumonia,ear infections,meningitis, orskin infections.
An A/G ratio cannot diagnose any medical condition on its own, but it can point your healthcare provider in the direction of possible causes.
Other tests can help characterize the nature of the problem and help narrow the causes. These involve lab tests like:
Imaging tests and specialist procedures may be also used if a gastrointestinal disease or cancer is suspected, such as:
Summary
A low A/G ratio may be due to kidney disease, liver disease, chronic infections, type 2 diabetes, malnutrition, certain autoimmune diseases, and cancers. A high A/G ratio may also be due to kidney disease as well as severe dehydration, pregnancy, and antibody deficiencies.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Total protein and albumin/globulin (A/G) ratio.MedlinePlus.Albumin blood test.Icahn School of Medicine at Mount Sinai.Albumin: blood (serum) test information.MedlinePlus.Globulin test.Icahn School of Medicine at Mount Sinai.Serum globulin electrophoresis.Yashoda Hospitals.What is a globulin/AG ratio?MedlinePlus.Total protein and albumin/globulin (A/G) ratio.St. Luke’s/BJC Health System.Total protein and A/G ratio.Soeters PB, Wolfe RR, Shenkin A.Hypoalbuminemia: pathogenesis and clinical significance.JPEN J Parenter Enteral Nutr.2019;43(2):181–193. doi:10.1002/jpen.1451Ocskay K, Vinkó Z, Németh D, et al.Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality.Sci Rep.2021:11:24158. doi:10.1038/s41598-021-03449-8Cobanoglu RK, Senturk T.The role of albumin-to-globulin ratio in undifferentiated arthritis: rheumatoid arthritis versus primary Sjögren syndrome.Arch Rheumatol.2022;37(2):245–251. doi:10.46497/ArchRheumatol.2022.8742Levitt DG, Levitt MD.Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.Clin Exp Gastroenterol.2017;10:147–168. doi:10.2147/CEG.S136803Guo HW, Yuan TZ, Chen JX, Zheng Y.Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: a meta-analysis.PLoS One.2018;13(1):e0189839. doi:10.1371/journal.pone.0189839National Cancer Institute.Plasma cell neoplasms (including multiple myeloma) treatment (PDQ).Wang J, Liu F, Kong R, Han X.Association between globulin and diabetic nephropathy in type2 diabetes mellitus patients: a cross-sectional study.Front Endocrinol (Lausanne).2022;13:890273. doi:10.3389/fendo.2022.890273Park J, Kim HJ, Kim J, Choi YB, Lee MJ.Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: a 12-year community-based prospective study.PLoS One.2020;15(9):e0238421. doi:10.1371/journal.pone.0238421Gburek J, Konopska B, Golab K.Renal handling of albumin—from early findings to current concepts.Int J Mol Sci.2021;22(11):5809. doi:10.3390/ijms22115809Hao S, You J, Chen L, et al.Changes in pregnancy-related serum biomarkers early in gestation are associated with later development of preeclampsia.PLoS One. 2020;15(3):e0230000. doi:10.1371/journal.pone.0230000Columbia University Irvine Medical Center.Antibody deficiencies.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Total protein and albumin/globulin (A/G) ratio.MedlinePlus.Albumin blood test.Icahn School of Medicine at Mount Sinai.Albumin: blood (serum) test information.MedlinePlus.Globulin test.Icahn School of Medicine at Mount Sinai.Serum globulin electrophoresis.Yashoda Hospitals.What is a globulin/AG ratio?MedlinePlus.Total protein and albumin/globulin (A/G) ratio.St. Luke’s/BJC Health System.Total protein and A/G ratio.Soeters PB, Wolfe RR, Shenkin A.Hypoalbuminemia: pathogenesis and clinical significance.JPEN J Parenter Enteral Nutr.2019;43(2):181–193. doi:10.1002/jpen.1451Ocskay K, Vinkó Z, Németh D, et al.Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality.Sci Rep.2021:11:24158. doi:10.1038/s41598-021-03449-8Cobanoglu RK, Senturk T.The role of albumin-to-globulin ratio in undifferentiated arthritis: rheumatoid arthritis versus primary Sjögren syndrome.Arch Rheumatol.2022;37(2):245–251. doi:10.46497/ArchRheumatol.2022.8742Levitt DG, Levitt MD.Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.Clin Exp Gastroenterol.2017;10:147–168. doi:10.2147/CEG.S136803Guo HW, Yuan TZ, Chen JX, Zheng Y.Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: a meta-analysis.PLoS One.2018;13(1):e0189839. doi:10.1371/journal.pone.0189839National Cancer Institute.Plasma cell neoplasms (including multiple myeloma) treatment (PDQ).Wang J, Liu F, Kong R, Han X.Association between globulin and diabetic nephropathy in type2 diabetes mellitus patients: a cross-sectional study.Front Endocrinol (Lausanne).2022;13:890273. doi:10.3389/fendo.2022.890273Park J, Kim HJ, Kim J, Choi YB, Lee MJ.Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: a 12-year community-based prospective study.PLoS One.2020;15(9):e0238421. doi:10.1371/journal.pone.0238421Gburek J, Konopska B, Golab K.Renal handling of albumin—from early findings to current concepts.Int J Mol Sci.2021;22(11):5809. doi:10.3390/ijms22115809Hao S, You J, Chen L, et al.Changes in pregnancy-related serum biomarkers early in gestation are associated with later development of preeclampsia.PLoS One. 2020;15(3):e0230000. doi:10.1371/journal.pone.0230000Columbia University Irvine Medical Center.Antibody deficiencies.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Total protein and albumin/globulin (A/G) ratio.MedlinePlus.Albumin blood test.Icahn School of Medicine at Mount Sinai.Albumin: blood (serum) test information.MedlinePlus.Globulin test.Icahn School of Medicine at Mount Sinai.Serum globulin electrophoresis.Yashoda Hospitals.What is a globulin/AG ratio?MedlinePlus.Total protein and albumin/globulin (A/G) ratio.St. Luke’s/BJC Health System.Total protein and A/G ratio.Soeters PB, Wolfe RR, Shenkin A.Hypoalbuminemia: pathogenesis and clinical significance.JPEN J Parenter Enteral Nutr.2019;43(2):181–193. doi:10.1002/jpen.1451Ocskay K, Vinkó Z, Németh D, et al.Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality.Sci Rep.2021:11:24158. doi:10.1038/s41598-021-03449-8Cobanoglu RK, Senturk T.The role of albumin-to-globulin ratio in undifferentiated arthritis: rheumatoid arthritis versus primary Sjögren syndrome.Arch Rheumatol.2022;37(2):245–251. doi:10.46497/ArchRheumatol.2022.8742Levitt DG, Levitt MD.Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.Clin Exp Gastroenterol.2017;10:147–168. doi:10.2147/CEG.S136803Guo HW, Yuan TZ, Chen JX, Zheng Y.Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: a meta-analysis.PLoS One.2018;13(1):e0189839. doi:10.1371/journal.pone.0189839National Cancer Institute.Plasma cell neoplasms (including multiple myeloma) treatment (PDQ).Wang J, Liu F, Kong R, Han X.Association between globulin and diabetic nephropathy in type2 diabetes mellitus patients: a cross-sectional study.Front Endocrinol (Lausanne).2022;13:890273. doi:10.3389/fendo.2022.890273Park J, Kim HJ, Kim J, Choi YB, Lee MJ.Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: a 12-year community-based prospective study.PLoS One.2020;15(9):e0238421. doi:10.1371/journal.pone.0238421Gburek J, Konopska B, Golab K.Renal handling of albumin—from early findings to current concepts.Int J Mol Sci.2021;22(11):5809. doi:10.3390/ijms22115809Hao S, You J, Chen L, et al.Changes in pregnancy-related serum biomarkers early in gestation are associated with later development of preeclampsia.PLoS One. 2020;15(3):e0230000. doi:10.1371/journal.pone.0230000Columbia University Irvine Medical Center.Antibody deficiencies.
MedlinePlus.Total protein and albumin/globulin (A/G) ratio.
MedlinePlus.Albumin blood test.
Icahn School of Medicine at Mount Sinai.Albumin: blood (serum) test information.
MedlinePlus.Globulin test.
Icahn School of Medicine at Mount Sinai.Serum globulin electrophoresis.
Yashoda Hospitals.What is a globulin/AG ratio?
St. Luke’s/BJC Health System.Total protein and A/G ratio.
Soeters PB, Wolfe RR, Shenkin A.Hypoalbuminemia: pathogenesis and clinical significance.JPEN J Parenter Enteral Nutr.2019;43(2):181–193. doi:10.1002/jpen.1451
Ocskay K, Vinkó Z, Németh D, et al.Hypoalbuminemia affects one third of acute pancreatitis patients and is independently associated with severity and mortality.Sci Rep.2021:11:24158. doi:10.1038/s41598-021-03449-8
Cobanoglu RK, Senturk T.The role of albumin-to-globulin ratio in undifferentiated arthritis: rheumatoid arthritis versus primary Sjögren syndrome.Arch Rheumatol.2022;37(2):245–251. doi:10.46497/ArchRheumatol.2022.8742
Levitt DG, Levitt MD.Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.Clin Exp Gastroenterol.2017;10:147–168. doi:10.2147/CEG.S136803
Guo HW, Yuan TZ, Chen JX, Zheng Y.Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: a meta-analysis.PLoS One.2018;13(1):e0189839. doi:10.1371/journal.pone.0189839
National Cancer Institute.Plasma cell neoplasms (including multiple myeloma) treatment (PDQ).
Wang J, Liu F, Kong R, Han X.Association between globulin and diabetic nephropathy in type2 diabetes mellitus patients: a cross-sectional study.Front Endocrinol (Lausanne).2022;13:890273. doi:10.3389/fendo.2022.890273
Park J, Kim HJ, Kim J, Choi YB, Lee MJ.Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: a 12-year community-based prospective study.PLoS One.2020;15(9):e0238421. doi:10.1371/journal.pone.0238421
Gburek J, Konopska B, Golab K.Renal handling of albumin—from early findings to current concepts.Int J Mol Sci.2021;22(11):5809. doi:10.3390/ijms22115809
Hao S, You J, Chen L, et al.Changes in pregnancy-related serum biomarkers early in gestation are associated with later development of preeclampsia.PLoS One. 2020;15(3):e0230000. doi:10.1371/journal.pone.0230000
Columbia University Irvine Medical Center.Antibody deficiencies.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
