Association of Serum Albumin-to-globulin Ratio (AGR) With All-Cause and Cause-Specific Mortality Among Individuals With Diabetes
Authors' conclusion
AGR is a promising biomarker in risk predictions for long-term mortality in diabetic individuals, particularly in those younger than 60 years and heavy drinkers.
Study context
- Population
- Adults with diabetes, National Health and Nutrition Examination Survey (NHANES) 1999–2018, mortality linked to National Death Index through December 31, 2019
- Participants
- 8,508 adults
- Exposure
- Highest vs lowest serum AGR quartile
- Outcome
- All-cause, CVD and cancer mortality
- Follow-up
- Average 9.61 years
Methodological detailsNHANES 1999–2018, weighted Cox proportional-hazards models, multivariate-adjusted
- NHANES 1999–2018
- Weighted Cox proportional-hazards models
- Multivariate-adjusted
Main finding
As reported in the abstract
Mortality, highest AGR quartile
Estimate (95% CI)P value
Highest AGR quartile
multivariate-adjusted HR, all-cause mortality 0.51(0.42–0.60)
P < 0.0001for trendHighest AGR quartile
multivariate-adjusted HR, CV mortality 0.62(0.46–0.83)
P < 0.001for trendHighest AGR quartile
multivariate-adjusted HR, cancer mortality 0.57(0.39–0.85)
P < 0.01for trend- All-cause deaths
- 2415
- CV deaths
- 688
- Cancer deaths
- 413
Observational data: associations, not effects.
Further findings
Mortality per 1-unit rise in natural log-transformed serum AGR
- Decreased risk of all-cause death
- 73%
- Decreased risk of cardiovascular disease (CVD) mortality
- 60%
- Decreased risk of cancer mortality
- 63%
- All P < .001
Stratified and sensitivity analyses
- Same relationships in stratified and sensitivity analyses
Original publication
Association of Serum AGR With All-Cause and Cause-Specific Mortality Among Individuals With Diabetes. J Clin Endocrinol Metab. Published 4 April 2024. doi:10.
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