Globulin

Understanding Globulin:

• Globulin = Total Protein minus Albumin
• Includes immunoglobulins (IgG, IgA, IgM), complement proteins, and transport proteins
• High globulin → chronic inflammation, infection, or autoimmune activity
• Low globulin → immunodeficiency or liver dysfunction

If Elevated:

• Check CRP and ESR to assess inflammation
• Consider chronic infections, autoimmune conditions
• AAS generally don't elevate globulin — if elevated, investigate underlying cause
• Dehydration can mildly elevate (check hydration status)

If Low:

• May indicate immunodeficiency — check full blood count and differential
• Severe liver disease can reduce globulin production
• Less clinically significant than albumin in most contexts

Albumin/Globulin Ratio:

• Normal A/G ratio: 1.1-2.5
• Low A/G ratio (high globulin relative to albumin) → warrants investigation for chronic inflammatory conditions

References:

• Cabrera, D., Arab, J. P., & Arrese, M. (2019). UDCA, NorUDCA, and TUDCA in liver diseases: A review of their mechanisms of action and clinical applications. Handbook of Experimental Pharmacology, 256, 237-264. DOI: 10.1007/164_2019_241