What is the albumin/globulin (A/G) ratio, and what conditions commonly alter it?

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The albumin/globulin ratio is a measure of the balance between the major serum proteins albumin and globulins. Albumin, made by the liver, helps maintain oncotic pressure and carries various substances; globulins include a broad group of proteins, notably immunoglobulins produced by the immune system. The ratio is calculated as albumin divided by globulin.

When globulins are high, as in chronic liver disease with immune activation or other conditions with hypergammaglobulinemia, the denominator increases and the ratio falls. When globulins are low, such as in agammaglobulinemia or underproduction of globulins, the denominator decreases and the ratio rises. Chronic liver disease can also lower albumin production, further decreasing the A/G ratio. The option described matches this pattern: a decreased A/G ratio with high globulins or low albumin, and an increased A/G ratio with underproduction of globulins.