Which condition is commonly associated with a decreased albumin/globulin ratio?

• A. Chronic liver disease.
• B. Agammaglobulinemia.
• C. Underproduction of globulins.
• D. Dehydration.

Answer: (A)

The albumin/globulin ratio reflects the balance between the liver’s production of albumin and the various globulins produced by immune and other cells. In chronic liver disease, albumin synthesis falls because the damaged liver cannot make as much albumin, while globulin production can stay the same or even rise due to ongoing immune activity. This shift lowers the A/G ratio, making a decreased ratio a common finding in chronic liver conditions.

If globulins were underproduced, the ratio would actually increase, since there would be less globulin relative to albumin. Agammaglobulinemia reduces immunoglobulins, which would tend to raise the ratio rather than lower it. Dehydration concentrates plasma proteins but does not specifically cause a decreased albumin/globulin ratio; the ratio is typically normal or may even rise.