title: Serum albumin to globulin ratio is related to cognitive decline via reflection of homeostasis: a nested case-control study.
abstract: BACKGROUND
  Recent research suggests that several pathogenetic factors, including aging, genetics, inflammation, dyslipidemia, diabetes, and infectious diseases, influence cognitive decline (CD) risk. However, no definitive candidate causes have been identified. The present study evaluated whether certain serum parameters predict CD.
  
  
  METHODS
  A total of 151 participants were assessed for CD using the Mini-Mental State Examination (MMSE), and 34 participants were identified as showing CD.
  
  
  RESULTS
  Among CD predictive risk factors, Helicobacter pylori seropositivity was significantly predictive of CD risk, more so than classical risk factors, including white matter lesions and arterial stiffness [adjusted odds ratio (OR) = 4.786, 95% confidence interval (CI) = 1.710-13.39]. A multivariate analysis indicated that the albumin to globulin (A/G) ratio was the only factor that significantly lowered CD risk (OR = 0.092, 95% CI = 0.010-0.887). A/G ratio also was positively correlated with MMSE scores and negatively correlated with disruption of homeostatic factors (i.e., non-high-density lipoprotein, hemoglobin A1c, and high-sensitive C-reactive protein).
  
  
  CONCLUSIONS
  The current study results suggest that the A/G ratio is related to cognitive decline and may reflect homeostatic alterations.
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. tkoyama@koto.kpu-m.ac.jp.
authors.forename: Teruhide
authors.identifier: http://orcid.org/0000-0002-8161-368X
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Nagato
authors.initials: N
authors.lastname: Kuriyama
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Ozaki
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsui
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Watanabe
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.|Department of Dental Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Fumitaro
authors.initials: F
authors.lastname: Miyatani
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Pharmacology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohshima
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.|Department of Molecular Pathobiology of Brain Diseases, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tokuda
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Mizuta
authors.affiliation: Endoscopy Department, Kindai University Nara Hospital, 1248-1 Otoda-cho, Ikoma, 630-0293, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Kyoto Industrial Health Association, 67 Nishinokyo Kitatsuboi-cho, Nakagyo-ku, Kyoto, 604-8472, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Kyoto Industrial Health Association, 67 Nishinokyo Kitatsuboi-cho, Nakagyo-ku, Kyoto, 604-8472, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Director of North Medical Center, Kyoto Prefectural University of Medicine, 481 Aza-Otokoyama, Yosano-cho, Yosa-gun, Kyoto, 629-2261, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000097:blood*; D005260:Female; D005916:Globulins / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D005916:Globulins; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: Albumin to globulin ratio; Cognitive decline; Helicobacter pylori; Homeostatic alteration; Mini-mental state examination