Association of Serum Albumin, Globulin and Albumin-Globulin Ratio with Severity of Psoriasis

Abstract

Background: Psoriasis is a chronic inflammatory skin disease with substantial morbidity. Alterations in serum albumin, globulin and albumin–globulin (Albumin-Globulin) ratio have been reported in psoriasis, but their relationship with disease severity is not well defined in Bangladesh. Objective: To assess the association of serum albumin, globulin and Albumin-Globulin ratio with psoriasis severity according to the Psoriasis Area Severity Index (PASI). Methods: A 12-months cross sectional study was conducted at the Department of Dermatology and Venereology, Dhaka Medical College Hospital, including 50 patients with chronic plaque psoriasis and 50 apparently healthy controls selected by purposive sampling. PASI was used to categorize psoriasis as mild, moderate or severe. Serum albumin, globulin and Albumin-Globulin ratio were measured by standard biochemical methods. Data were analyzed using SPSS Version 22 with Student’s t test, Chi square test, one way ANOVA and Pearson’s correlation. A p value <0.05 was considered significant. Results: Psoriasis patients had a mean age of 44.02±12.15 years with male predominance (58%). Mean serum albumin (3.77±0.25 vs 4.47±0.30 g/dL, p<0.001) and Albumin-Globulin ratio (1.21±0.17 vs 1.55±0.15, p<0.001) were significantly lower in cases than controls, whereas serum globulin was higher (3.15±0.26 vs 2.89±0.18 g/dL, p<0.001). Among patients, 36% had mild, 44% moderate and 20% severe psoriasis. Serum albumin (p=0.002), globulin (p=0.027) and Albumin-Globulin ratio (p=0.001) differed significantly across PASI categories. PASI correlated negatively with albumin (r=−0.469, p=0.001) and Albumin-Globulin ratio (r=−0.482, p<0.001) and positively with globulin (r=0.360, p=0.010). Conclusion: Serum albumin, globulin and Albumin-Globulin ratio are significantly altered in Bangladeshi patients with psoriasis and show strong associations with PASI severity, suggesting potential as simple adjunct markers of disease burden. Keywords: Psoriasis, serum albumin, serum globulin, albumin-globulin ratio, PASI score