Biomarkers · Liver & Nutritional

Albumin:Globulin Ratio (A/G)

Higher values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 24% lower risk of death. We found the same pattern in NHANES

A/G and risk of death

NHANES, our fit with 95% CIPublished curve

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.

Risk of death per SD (NHANES)0.76×95% CI 0.74–0.78 · 48,307 adults, 7,024 deaths

Published risk of death0.55×highest vs lowest AGR quartile (protective form, Q4 vs Q1) (95% CI 0.45–0.67) · NHANES 2003-2018 adults with cardiovascular-kidney-metabolic (CKM) syndrome, mortality follow-up through 31 Dec 2019

Value of the measurement+0.041gain in concordance within age bands; rank 4 of 56 · all tests

A/G by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (ratio), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	1.03	1.25	1.41	1.57	1.79	1,429	NHANES 2017-2018
All	40-59	1.00	1.20	1.38	1.52	1.75	1,548	NHANES 2017-2018
All	60+	1.00	1.23	1.35	1.54	1.82	1,890	NHANES 2017-2018
All	all	1.00	1.23	1.38	1.54	1.79	4,867	NHANES 2017-2018
Men	20-39	1.14	1.34	1.48	1.64	1.88	684	NHANES 2017-2018
Men	40-59	1.05	1.26	1.41	1.55	1.75	723	NHANES 2017-2018
Men	60+	1.00	1.24	1.39	1.56	1.84	958	NHANES 2017-2018
Men	all	1.06	1.28	1.44	1.59	1.84	2,365	NHANES 2017-2018
Women	20-39	0.97	1.16	1.32	1.48	1.67	745	NHANES 2017-2018
Women	40-59	0.94	1.16	1.32	1.47	1.75	825	NHANES 2017-2018
Women	60+	1.03	1.20	1.33	1.52	1.79	932	NHANES 2017-2018
Women	all	0.97	1.18	1.33	1.48	1.74	2,502	NHANES 2017-2018

Sources

Risk curve: Wang G 2025 (PMID 40678773): all-cause HR 0.55 (0.45-0.67) highest vs lowest AGR quartile (protective form, Q4 vs Q1). Scaled to US values (NHANES).
Wang G, Li G, Wang P, Zang M, Pu J. Association between albumin to globulin ratio and all-cause and cardiovascular mortality among individuals with cardiovascular-kidney-metabolic syndrome: results from NHANES 2003 to 2018. Front Nutr. 2025;12:1622590.
NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.

Map Albumin:Globulin Ratio (A/G) against another biomarker.

Map A/G against another marker