Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults

B. Suh, S. Park, Dong Wook Shin, J. M. Yun, B. Keam, H. K. Yang, E. Ahn, H. Lee, J. H. Park, B. Cho

Research output: Contribution to journalArticle

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Abstract

Background: Chronic inflammation is known to be one of the main steps in carcinogenesis. Identification of those with chronic inflammation may help identify subjects at risk of cancer. Previous studies have reported low albumin-to-globulin ratio (AGR) to be associated with increased cancer mortality in cancer patients, but there has been no study based on healthy populations. Patients and methods: Our retrospective cohort study involved 26 974 generally healthy adults aged 30 or older who visited Seoul National University Hospital Health Promotion Center for self-referred health checkup. National medical service claims data were used to determine cancer incidence, and Korean death registry data was used to determine mortality. Median follow-up time for survival was 5.9 years (interquartile range 4.1 years). Results: Compared with subjects with AGR ≥ 1.5, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR showed adjusted hazard ratio (aHR) 2.69 (95% confidence interval, CI, 1.54-4.72) and aHR 6.71 (95% CI 3.56-12.66) for all-cause mortality, aHR 2.95 (95% CI 1.42-6.11) and aHR 4.38 (95% CI 1.57-12.25) for cancer mortality, and aHR 2.07 (95% CI 1.28- 3.36) and aHR 3.99 (95% CI 2.10-7.58) for cancer incidence, respectively. When cancer incidence events after 2 years from baseline were separately analyzed, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR were associated with aHR 1.88 (95% CI 1.01-3.48) and aHR 2.55 (95% CI 1.03-7.11) for cancer incidence, respectively. Cancer events were increased in all types of cancer, but especially in liver and hematologic malignancies. Conclusions: Low AGR is a risk factor for cancer incidence and mortality, both short- and long terms, in a generally healthy screened population. The results of this study need to be replicated in larger studies, along with the determination of the sensitivity and other diagnostic values of low AGR.

Original languageEnglish
Pages (from-to)2260-2266
Number of pages7
JournalAnnals of Oncology
Volume25
Issue number11
DOIs
Publication statusPublished - 2014 Nov 1

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Globulins
Albumins
Mortality
Incidence
Neoplasms
Inflammation
Hematologic Neoplasms
Health Promotion
Population
Registries
Carcinogenesis
Cohort Studies
Retrospective Studies
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology

Cite this

Suh, B. ; Park, S. ; Shin, Dong Wook ; Yun, J. M. ; Keam, B. ; Yang, H. K. ; Ahn, E. ; Lee, H. ; Park, J. H. ; Cho, B. / Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. In: Annals of Oncology. 2014 ; Vol. 25, No. 11. pp. 2260-2266.
@article{4b27ca65ddd340618512fdf4fb495bbf,
title = "Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults",
abstract = "Background: Chronic inflammation is known to be one of the main steps in carcinogenesis. Identification of those with chronic inflammation may help identify subjects at risk of cancer. Previous studies have reported low albumin-to-globulin ratio (AGR) to be associated with increased cancer mortality in cancer patients, but there has been no study based on healthy populations. Patients and methods: Our retrospective cohort study involved 26 974 generally healthy adults aged 30 or older who visited Seoul National University Hospital Health Promotion Center for self-referred health checkup. National medical service claims data were used to determine cancer incidence, and Korean death registry data was used to determine mortality. Median follow-up time for survival was 5.9 years (interquartile range 4.1 years). Results: Compared with subjects with AGR ≥ 1.5, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR showed adjusted hazard ratio (aHR) 2.69 (95{\%} confidence interval, CI, 1.54-4.72) and aHR 6.71 (95{\%} CI 3.56-12.66) for all-cause mortality, aHR 2.95 (95{\%} CI 1.42-6.11) and aHR 4.38 (95{\%} CI 1.57-12.25) for cancer mortality, and aHR 2.07 (95{\%} CI 1.28- 3.36) and aHR 3.99 (95{\%} CI 2.10-7.58) for cancer incidence, respectively. When cancer incidence events after 2 years from baseline were separately analyzed, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR were associated with aHR 1.88 (95{\%} CI 1.01-3.48) and aHR 2.55 (95{\%} CI 1.03-7.11) for cancer incidence, respectively. Cancer events were increased in all types of cancer, but especially in liver and hematologic malignancies. Conclusions: Low AGR is a risk factor for cancer incidence and mortality, both short- and long terms, in a generally healthy screened population. The results of this study need to be replicated in larger studies, along with the determination of the sensitivity and other diagnostic values of low AGR.",
author = "B. Suh and S. Park and Shin, {Dong Wook} and Yun, {J. M.} and B. Keam and Yang, {H. K.} and E. Ahn and H. Lee and Park, {J. H.} and B. Cho",
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Suh, B, Park, S, Shin, DW, Yun, JM, Keam, B, Yang, HK, Ahn, E, Lee, H, Park, JH & Cho, B 2014, 'Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults', Annals of Oncology, vol. 25, no. 11, pp. 2260-2266. https://doi.org/10.1093/annonc/mdu274

Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. / Suh, B.; Park, S.; Shin, Dong Wook; Yun, J. M.; Keam, B.; Yang, H. K.; Ahn, E.; Lee, H.; Park, J. H.; Cho, B.

In: Annals of Oncology, Vol. 25, No. 11, 01.11.2014, p. 2260-2266.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults

AU - Suh, B.

AU - Park, S.

AU - Shin, Dong Wook

AU - Yun, J. M.

AU - Keam, B.

AU - Yang, H. K.

AU - Ahn, E.

AU - Lee, H.

AU - Park, J. H.

AU - Cho, B.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background: Chronic inflammation is known to be one of the main steps in carcinogenesis. Identification of those with chronic inflammation may help identify subjects at risk of cancer. Previous studies have reported low albumin-to-globulin ratio (AGR) to be associated with increased cancer mortality in cancer patients, but there has been no study based on healthy populations. Patients and methods: Our retrospective cohort study involved 26 974 generally healthy adults aged 30 or older who visited Seoul National University Hospital Health Promotion Center for self-referred health checkup. National medical service claims data were used to determine cancer incidence, and Korean death registry data was used to determine mortality. Median follow-up time for survival was 5.9 years (interquartile range 4.1 years). Results: Compared with subjects with AGR ≥ 1.5, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR showed adjusted hazard ratio (aHR) 2.69 (95% confidence interval, CI, 1.54-4.72) and aHR 6.71 (95% CI 3.56-12.66) for all-cause mortality, aHR 2.95 (95% CI 1.42-6.11) and aHR 4.38 (95% CI 1.57-12.25) for cancer mortality, and aHR 2.07 (95% CI 1.28- 3.36) and aHR 3.99 (95% CI 2.10-7.58) for cancer incidence, respectively. When cancer incidence events after 2 years from baseline were separately analyzed, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR were associated with aHR 1.88 (95% CI 1.01-3.48) and aHR 2.55 (95% CI 1.03-7.11) for cancer incidence, respectively. Cancer events were increased in all types of cancer, but especially in liver and hematologic malignancies. Conclusions: Low AGR is a risk factor for cancer incidence and mortality, both short- and long terms, in a generally healthy screened population. The results of this study need to be replicated in larger studies, along with the determination of the sensitivity and other diagnostic values of low AGR.

AB - Background: Chronic inflammation is known to be one of the main steps in carcinogenesis. Identification of those with chronic inflammation may help identify subjects at risk of cancer. Previous studies have reported low albumin-to-globulin ratio (AGR) to be associated with increased cancer mortality in cancer patients, but there has been no study based on healthy populations. Patients and methods: Our retrospective cohort study involved 26 974 generally healthy adults aged 30 or older who visited Seoul National University Hospital Health Promotion Center for self-referred health checkup. National medical service claims data were used to determine cancer incidence, and Korean death registry data was used to determine mortality. Median follow-up time for survival was 5.9 years (interquartile range 4.1 years). Results: Compared with subjects with AGR ≥ 1.5, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR showed adjusted hazard ratio (aHR) 2.69 (95% confidence interval, CI, 1.54-4.72) and aHR 6.71 (95% CI 3.56-12.66) for all-cause mortality, aHR 2.95 (95% CI 1.42-6.11) and aHR 4.38 (95% CI 1.57-12.25) for cancer mortality, and aHR 2.07 (95% CI 1.28- 3.36) and aHR 3.99 (95% CI 2.10-7.58) for cancer incidence, respectively. When cancer incidence events after 2 years from baseline were separately analyzed, subjects with 1.1 > AGR ≥ 1.0 and 1.0 > AGR were associated with aHR 1.88 (95% CI 1.01-3.48) and aHR 2.55 (95% CI 1.03-7.11) for cancer incidence, respectively. Cancer events were increased in all types of cancer, but especially in liver and hematologic malignancies. Conclusions: Low AGR is a risk factor for cancer incidence and mortality, both short- and long terms, in a generally healthy screened population. The results of this study need to be replicated in larger studies, along with the determination of the sensitivity and other diagnostic values of low AGR.

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U2 - 10.1093/annonc/mdu274

DO - 10.1093/annonc/mdu274

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JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

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