Elevated serum globulin gap as a highly reliable marker of elevated erythrocyte sedimentation rate in patients with systemic rheumatic diseases

Stohl, William; Kenol, Beatrice; Kelly, Andrew; Correa, Aditi Ananth; Panush, Richard S.

doi:10.1016/j.semarthrit.2019.05.001

Cited by 15 publications

(12 citation statements)

References 22 publications

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“…For example, glucose is an important energy source of animal body, and the decrease of glucose content may be closely related to abnormal glucose metabolism, severe liver disease, malnutrition ( 60 ). The decrease of serum triglyceride is commonly associated with impaired liver function and malnutrition ( 61 ). Serum total cholesterol is mainly synthesized by the liver and is the main component that synthesizes a variety of hormones and forms the cell membrane ( 62 ).…”

Section: Discussionmentioning

confidence: 99%

“…Serum total cholesterol is mainly synthesized by the liver and is the main component that synthesizes a variety of hormones and forms the cell membrane ( 62 ). As a reflection of protein metabolism and immune function, the level of serum total protein can reflect the strength of protein synthesis and metabolism ( 61 ). In this study, pletasin is beneficial to improve the disorder of lipid metabolism and increase feed conversion rate of broilers to a certain extent by changing the contents of serum glucose, triglyceride and total cholesterol.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of the Antimicrobial Peptide Plectasin on the Growth Performance, Intestinal Health, and Immune Function of Yellow-Feathered Chickens

et al. 2021

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The goal of the study was to test the effects of an antibiotic substitute, plectasin, on the growth performance, immune function, intestinal morphology and structure, intestinal microflora, ileal mucosal layer construction and tight junctions, ileal immune-related cytokines, and blood biochemical indices of yellow-feathered chickens. A total of 1,500 one-day-old yellow-feathered chicks were randomly divided into four dietary treatment groups with five replicates in each group and 75 yellow-feathered chicks in each replication, as follows: basal diet (group A); basal diet supplemented with 10 mg enramycin/kg of diet (group B), basal diet supplemented with 100 mg plectasin/kg of diet (group C), and basal diet supplemented with 200 mg plectasin/kg of diet (group D). It was found that the dietary antimicrobial peptide plectasin could improve the ADG and had better F/G for the overall period of 1–63 days. Dietary plectasin can enhance H9N2 avian influenza virus (AIV) and Newcastle disease virus (NDV) antibody levels of yellow-feathered chickens at 21, and 35 days of age. Dietary plectasin can enhance the intestine structure, inhibit Escherichia coli and proinflammatory cytokines in the ileum, and ameliorate the blood biochemical indices of yellow-feathered chickens at 21 days of age. This study indicates that the antimicrobial peptide plectasin has beneficial effects on the growth performance, intestinal health and immune function of yellow-feathered chickens.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effect of the Antimicrobial Peptide Plectasin on the Growth Performance, Intestinal Health, and Immune Function of Yellow-Feathered Chickens

et al. 2021

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“…Low serum AG ratios are frequently observed in patients with rheumatoid arthritis and bronchiectasis, both of which are major chronic inflammatory diseases [16]. In patients with systemic rheumatic diseases, serum AG ratio was correlated with CRP and erythrocyte sedimentation rate concentrations, supporting the significant association of serum AG ratio with inflammation [20]. Given that metabolic alteration caused by chronic diseases and chronic inflammation are implicated in CKD development, we hypothesized that serum AG ratio may be useful for predicting the risk of declining kidney function.…”

Section: Plos Onementioning

confidence: 87%

“…Low serum AG ratios have been observed in patients with rheumatoid arthritis and bronchiectasis, both of which are major chronic inflammatory diseases [16]. In a study of patients with systemic rheumatic diseases, serum AG ratio was correlated with CRP and erythrocyte sedimentation rate concentrations, suggesting the significant association of serum AG ratio with inflammation [20].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: A 12-year community-based prospective study

Park

Kim

et al. 2020

PLoS ONE

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Background Inflammation plays a pivotal role in the pathogenesis of chronic kidney disease (CKD). Significant association between serum albumin-to-globulin (AG) ratio and inflammation led us to investigate the prognostic value of serum AG ratio for incident CKD. Methods The predictive value of serum AG ratio, white blood cell (WBC), and C-reactive protein (CRP) for CKD development was assessed in 8,057 non-CKD participants from a community-based, prospective cohort in Korea. Serum AG ratio was calculated by following equation: serum albumin (g/L)/[serum total protein (g/L)-serum albumin (g/L)]. Incident CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m 2 and/or proteinuria of more than 1+ on dipstick. Results Median serum AG ratio was 1.38 (interquartile range, 1.28-1.52). During a mean follow-up duration of 9.1±3.7 years, 1,732 participants (21.5%) developed CKD. In a multivariable Cox analysis, a low serum AG ratio was significantly associated with an increased risk of incident CKD (Q1, serum AG ratio <1.26: hazard ratio [HR] = 1.651, 95% confidence interval [CI] = 1.406-1.938, Q5 as reference; per 0.2 decrease, HR = 1.170, 95% CI = 1.109-1.234). Serum AG ratio was the only indicator to improve the predictability of CKD development (net reclassification index = 0.158, P <0.001; integrated discrimination improvement = 0.005, P <0.001), compared with WBC or CRP.

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“…Clinically, an arbitrary value of 4.0 g/dL is sometimes considered an elevated gamma gap even though there are no studies demonstrating an association between an elevated gamma gap and various clinical conditions [4,11]. Nevertheless, an elevated gamma gap of 4.0 g/dL may trigger further work-up such as serum electrophoresis and free light chain assessment despite a lack of published evidence informing this testing [11][12][13][14][15]. Similarly, Western blots for HIV or serologic antigen and antibody testing for HCV may be performed in response to an elevated gamma gap.…”

Section: Introductionmentioning

confidence: 99%

Gamma gap thresholds and HIV, hepatitis C, and monoclonal gammopathy

et al. 2020

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Background An elevated gamma gap (>4 g/dL), the difference between serum total protein and albumin, can trigger testing for chronic infections or monoclonal gammopathy, despite a lack of evidence supporting this clinical threshold. Methods Using the National Health and Nutrition Examination Survey (NHANES) 1999-2014, gamma gap was derived in three subpopulations based on availability of testing for human immunodeficiency virus (HIV; N = 25,680), hepatitis C (HCV; N = 45,134), and monoclonal gammopathy of unknown significance (MGUS; N = 6,118). Disease status was confirmed by HIV antibody and Western blot, HCV RNA test, or electrophoresis with immunofixation. Sensitivity, specificity, and likelihood ratios were calculated for different gamma gap thresholds. Area under the curve (AUC) was used to assess performance and cubic splines were used to characterize the relationship between the gamma gap and each disease. Results Mean gamma gaps of participants with HIV, HCV, or MGUS ranged from 3.4-3.8 g/dL. The AUC was 0.80 (95%CI: 0.75,0.85) for HIV, 0.74 (0.72,0.76) for HCV, and 0.64 (0.60,0.69) for MGUS. An elevated gamma gap of over 4 g/dL corresponded to sensitivities of 39.3%, 19.0%, and 15.4% and specificities of 98.4%, 97.8%, and 95.4% for HIV, HCV, and MGUS, respectively. A higher prevalence of all three diseases was observed at both low and high gamma gaps.

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Elevated serum globulin gap as a highly reliable marker of elevated erythrocyte sedimentation rate in patients with systemic rheumatic diseases

Cited by 15 publications

References 22 publications

The Effect of the Antimicrobial Peptide Plectasin on the Growth Performance, Intestinal Health, and Immune Function of Yellow-Feathered Chickens

The Effect of the Antimicrobial Peptide Plectasin on the Growth Performance, Intestinal Health, and Immune Function of Yellow-Feathered Chickens

Predictive value of serum albumin-to-globulin ratio for incident chronic kidney disease: A 12-year community-based prospective study

Gamma gap thresholds and HIV, hepatitis C, and monoclonal gammopathy

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