Albumin Globulin Ratio Test Guide: Why the Test is Ordered and What the Results Mean

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Also referred to as A/G ratio, the albumin globulin ratio test is typically performed during annual and biannual physicals. It is done for a variety of reasons, such as certain kidney disorders and liver disorders, to analyze a patient’s nutritional status, and for certain other disorders. This test is done by analyzing a sample of the patient’s blood. This test is also referred to as total protein test.


Total protein measurements are capable of showing a patient’s nutritional status, as well as used to diagnose and screen for liver disease, kidney disease, and a number of other medical conditions. If the patient’s total protein is determined to be abnormal, other diagnostic tests must be done to determine what specific protein is abnormally high or abnormally low so that the correct and specific diagnosis can be determined and made.

What is this Test Used For and When is it Ordered?

The albumin globulin ratio is a part of a comprehensive metabolic panel that health care providers often order during a patient’s normal health checkup. When a patient has experienced a recent weight loss, this test may also be ordered to examine their overall nutritional status. Several other tests can be done along with this test when a patient has liver or kidney disorder symptoms, or to determine what is causing fluid to abnormally accumulate in the tissues (edema).

Preparation and Procedure

Most patients will not have to do anything to prepare for this test. If preparation is necessary, such as medication stoppage or adjustments, the patient’s doctor will discuss this with them prior to having this test done. A venous blood sample or a fingerstick blood sample is used to do this test. The patient will have their finger pricked with a lancet and the blood sample transferred to a strip of paper for testing. A venous sample is obtained by inserting a needle into the patient’s vein and letting enough blood collect in a special vial and then it is sent for testing.

What do the Results Mean?

The results of this test can provide health care providers with a lot of information about a patient’s overall health. If the patient has low protein levels, it can indicate a variety of different disease and conditions, such as:

  • Liver disorder
  • Kidney disorder
  • Severe malnutrition
  • Inflammatory bowel disease
  • Celiac disease

High protein levels can indicate the following conditions:

  • Chronic inflammation
  • Chronic infections
  • HIV
  • Viral hepatitis
  • Multiple myeloma
  • Bone marrow disorders

A low A/G ratio can indicate the following conditions:

  • Multiple myeloma
  • Cirrhosis
  • Autoimmune disease
  • Nephrotic syndrome

A high A/G ratio can indicate the following conditions:

  • Genetic deficiencies
  • Certain leukemias


Lab Tests Online. (2010). Total Protein and A/G Ratio. Retrieved on September 8, 2010 from Lab Tests Online:

WebMD. (2009). Total Serum Protein. Retrieved on September 8, 2010 from WebMD: