title: Synergistic association of serum albumin and globulin with coronary heart disease.
abstract: OBJECTIVE
  Serum albumin and globulin have important roles in atherosclerosis development; however, separate studies exploring the relationship between albumin or globulin and coronary heart disease (CHD) have been conducted. We explored whether there was a synergistic effect of albumin and globulin on the presence of CHD.
  
  
  METHODS
  A total of 395 patients aged 50-74 years with angiographically documented CHD were recruited, and 596 age- and sex-matched controls without CHD were randomly selected from the general population. The association of albumin and globulin with CHD was analyzed using conditional logistic regression after adjusting for traditional CHD risk factors.
  
  
  RESULTS
  Mean values of serum albumin and globulin were significantly lower in cases than in controls (p<0.001). In the fully adjusted model, compared with participants whose albumin (≥47.3 g/L) and globulin (≥25.6 g/L) levels were both higher than the median levels in these participants, the odds ratio for CHD was 1.59 (p= 0.048) for participants with higher albumin (≥47.3 g/L) but lower globulin (<25.6 g/L), 2.79 (p<0.001) for participants with lower albumin (<47.3 g/L) but higher globulin (≥25.6 g/L), and 16.03 (p<0.001) for participants with lower levels of both albumin (<47.3 g/L) and globulin (<25.6 g/L).
  
  
  CONCLUSIONS
  Low serum albumin and globulin are independently associated with CHD. The synergistic association of both low albumin and low globulin with CHD is greater than either one alone. The synergistic effect deserves further investigation.
authors.affiliation: Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Changsheng
authors.initials: C
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Jiayi
authors.initials: J
authors.lastname: Sun
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Yue
authors.initials: Y
authors.lastname: Qi
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lv
authors.forename: Dong
authors.initials: D
authors.lastname: Zhao
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003327:Coronary Disease / Q000097:blood* / Q000209:etiology*; D004357:Drug Synergism; D005260:Female; D005916:Globulins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D011795:Surveys and Questionnaires
chemical_list: D005916:Globulins; D012709:Serum Albumin