title: [Value of the albumin to globulin ratio in predicting severity and prognosis in myasthenia gravis patients].
abstract: OBJECTIVE
  To assess the predictive value of the albumin to globulin ratio (AGR) in evaluation of disease severity and prognosis in myasthenia gravis patients.
  
  
  METHODS
  A total of 135 myasthenia gravis (MG) patients were enrolled between February 2009 and March 2015. The AGR was detected on the first day of hospitalization and ranked from lowest to highest, and the patients were divided into three equal tertiles according to the AGR values, which were T1 (AGR <1.34), T2 (1.34≤AGR≤1.53) and T3 (AGR>1.53). The Kaplan-Meier curve was used to evaluate the prognostic value of AGR. Cox model analysis was used to evaluate the relevant factors. Multivariate Logistic regression analysis was used to find the predictors of myasthenia crisis during hospitalization.
  
  
  RESULTS
  The median length of hospital stay for each tertile was: for the T1 21 days (15-35.5), T2 18 days (14-27.5), and T3 16 days (12-22.5) (P<0.01), and Kaplan-Meier curves showed significant difference among the three groups. In the univariate model, serum albumin, creatinine, AGR and MGFA clinical classification were related to prognosis of myasthenia gravis. At the multivariate Cox regression analysis, the AGR (P<0.001) and MGFA clinical classification (P<0.001) were independent predictive factors of disease severity and prognosis in myasthenia gravis patients. Respectively, the hazard ratio (HR) were 4.655 (95% CI: 2.355-9.202) and 0.596 (95% CI: 0.492-0.723). Multivariate Logistic regression analysis showed the AGR (P<0.001) and MGFA clinical classification were related to myasthenia crisis.
  
  
  CONCLUSIONS
  The AGR may represent a simple, potentially useful predictive biomarker for evaluating the disease severity and prognosis of patients with myasthenia gravis.
authors.affiliation: Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
authors.forename: D H
authors.initials: DH
authors.lastname: Yang
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Su
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: Z B
authors.initials: ZB
authors.lastname: Chen
authors.forename: Z N
authors.initials: ZN
authors.lastname: Ding
authors.forename: Y Y
authors.initials: YY
authors.lastname: Weng
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: Q L
authors.initials: QL
authors.lastname: Tong
authors.forename: Y X
authors.initials: YX
authors.lastname: Han
authors.forename: X
authors.initials: X
authors.lastname: Zhang
mesh_terms: D005916:Globulins / Q000032:analysis*; D006801:Humans; D009157:Myasthenia Gravis / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D005916:Globulins; D012709:Serum Albumin