{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:01:09Z","timestamp":1790456469941,"version":"4.1.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004479","name":"Natural Science Foundation of Jiangxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>With the aging population of China, a higher prevalence of peripheral arterial disease (PAD) is observed. The albumin-globulin ratio (AGR) has a certain value in predicting cardiovascular mortality, but little research has been conducted on the association between AGR and PAD. Therefore, this study aims to explore the association between AGR and PAD in hypertensive adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study recruited a total of 28, 684 participants from March 2018 to August 2018 in Wuyuan County, Jiangxi Province, and Yuexi County, Anhui Province. A generalized additive model was utilized to analyze the relationship between AGR and PAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      A total of 24, 808 hypertensive adults were included in this study. The regression analysis of the generalized additive model revealed an inverse association between AGR and PAD when AGR was set as a continuous variable. Further analysis with AGR divided into quartiles indicated a lower risk of peripheral artery disease in the Q2, Q3, and Q4 groups compared with the Q1 group. Specifically, in the fully adjusted model (Model 3), the risk of peripheral artery disease in the Q2, Q3, and Q4 groups decreased by 11% (OR: 0.89; 95%CI: 0.71-1.10;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.278), 27% (OR: 0.73; 95%CI: 0.58-0.92;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.008), and 35% (OR: 0.65; 95%CI: 0.51-0.84;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) compared with the Q1 group, respectively. Subgroup analysis found that the relationship between AGR and PAD was more significant in the smoking and stroke populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A negative association was observed between AGR and PAD, with this relationship being particularly pronounced in individuals who smoke or have a history of stroke.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1839770","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:51:01Z","timestamp":1779943861000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The role of albumin\u2013globulin ratio in peripheral arterial disease among hypertensive adults: evidence from a large-scale multicenter study"],"prefix":"10.3389","volume":"17","author":[{"given":"Chao","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Department of Nutrition, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/cd9.0000000000000107","article-title":"Overview of the report on cardiovascular health and diseases in China 2021","volume":"20","year":"2022","journal-title":"Chin J Cardiovasc Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(19)30255-4","article-title":"Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis","volume":"7","author":"Song","year":"2019","journal-title":"Lancet Glob Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.10.047","article-title":"A national study of the prevalence and risk factors associated with peripheral arterial disease from China: The China Hypertension Survey, 2012-2015","volume":"275","author":"Wang","year":"2019","journal-title":"Int J Cardiol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.120.314595","article-title":"Epidemiology and risk of amputation in patients with diabetes mellitus and peripheral artery disease","volume":"40","author":"Barnes","year":"2020","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.118.036347","article-title":"Unraveling the risk of peripheral artery disease","volume":"138","author":"Joshi","year":"2018","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12872-019-1125-0","article-title":"Vitamin D deficiency is associated with risk of developing peripheral arterial disease in type 2 diabetic patients","volume":"19","author":"Yuan","year":"2019","journal-title":"BMC Cardiovasc Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000002577","article-title":"Hypertension and peripheral artery disease","volume":"38","author":"Clement","year":"2020","journal-title":"J Hypertens"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1177\/2047487319865378","article-title":"2017 ACC\/AHA blood pressure classification and incident peripheral artery disease: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"27","author":"Lu","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"49","DOI":"10.14744\/nci.2018.78800","article-title":"A practical marker to determining acute severe ulcerative colitis: CRP\/albumin ratio","volume":"7","author":"Sayar","year":"2020","journal-title":"North Clin Istanb"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2017.01.019","article-title":"Oxidative modifications of blood serum proteins in myasthenia gravis","volume":"305","author":"Adamczyk-Sowa","year":"2017","journal-title":"J Neuroimmunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182997","article-title":"Anticoagulant action of low, physiologic, and high albumin levels in whole blood","volume":"12","author":"Paar","year":"2017","journal-title":"PloS One"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.2095-140X.2019.10.009","article-title":"Analysis of the correlation between albumin\/globulin ratio and prognosis of patients with acute myocardial infarction undergoing percutaneous coronary intervention","volume":"31","author":"Zhou","year":"2019","journal-title":"J PLA Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2022.2076890","article-title":"Prognostic value of the albumin-to-globulin ratio in patients with colorectal cancer: A meta-analysis","volume":"74","author":"Quan","year":"2022","journal-title":"Nutr Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05595-2","article-title":"Pretreatment low prognostic nutritional index and low albumin-globulin ratio are predictive for overall survival in nasopharyngeal cancer","volume":"276","author":"Gundog","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2147\/ott.s159481","article-title":"Albumin\/globulin ratio is negatively correlated with PD-1 and CD25 mRNA levels in breast cancer patients","volume":"11","author":"Liu","year":"2018","journal-title":"Onco Targets Ther"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000003097","article-title":"Pretreatment albumin\/globulin ratio predicts the prognosis for small-cell lung cancer","volume":"95","author":"Zhou","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28648","article-title":"Baseline serum albumin is a predictive biomarker for patients with advanced pancreatic cancer treated with bevacizumab: a pooled analysis of 7 prospective trials of gemcitabine-based therapy with or without bevacizumab","volume":"120","author":"Pant","year":"2014","journal-title":"Cancer"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu274","article-title":"Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults","volume":"25","author":"Suh","year":"2014","journal-title":"Ann Oncol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12882-020-1707-1","article-title":"Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study","volume":"21","author":"Peng","year":"2020","journal-title":"BMC Nephrol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"19764","DOI":"10.1038\/s41598-020-73629-5","article-title":"Superiority of albumin-globulin ratio over albumin to predict mortality in patients undergoing peritoneal dialysis","volume":"10","author":"Tsai","year":"2020","journal-title":"Sci Rep"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/0003319712436577","article-title":"Value of albumin-globulin ratio as a predictor of all-cause mortality after non-ST elevation myocardial infarction","volume":"64","author":"Azab","year":"2013","journal-title":"Angiology"},{"key":"B22","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/s12933-017-0615-6","article-title":"Impact of empagliflozin on subclinical left ventricular dysfunctions and on the mechanisms involved in myocardial disease progression in type 2 diabetes: rationale and design of the EMPA-HEART trial","volume":"16","author":"Natali","year":"2017","journal-title":"Cardiovasc Diabetol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.atherosclerosis.2020.09.026","article-title":"The accuracy of toe brachial index and ankle brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis","volume":"315","author":"Herraiz-Adillo","year":"2020","journal-title":"Atherosclerosis"},{"key":"B24","doi-asserted-by":"publisher","first-page":"85","DOI":"10.7326\/0003-4819-148-2-200801150-00003","article-title":"Biomarkers of inflammation and thrombosis as predictors of near-term mortality in patients with peripheral arterial disease: a cohort study","volume":"148","author":"Vidula","year":"2008","journal-title":"Ann Intern Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1009-0126.2022.03.003","article-title":"The relationship between albumin-globulin ratio and lower extremity arterial disease in elderly diabetic patients","volume":"24","author":"Hui","year":"2022","journal-title":"Chin J Geriatric Heart Brain Dis"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00663-9","article-title":"Update on the pathophysiology and medical treatment of peripheral artery disease","volume":"19","author":"Golledge","year":"2022","journal-title":"Nat Rev Cardiol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"763","DOI":"10.5603\/kp.2017.0216","article-title":"2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS)","volume":"39","author":"Aboyans","year":"2018","journal-title":"Eur Heart J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/b978-1-4377-2930-6.00016-1","article-title":"Epidemiology of peripheral artery disease","volume":"116","author":"Criqui","year":"2015","journal-title":"Circ Res"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2016.179","article-title":"Peripheral artery disease: epidemiology and global perspectives","volume":"14","author":"Fowkes","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl441","article-title":"Inflammatory, haemostatic, and rheological markers for incident peripheral arterial disease: Edinburgh Artery Study","volume":"28","author":"Tzoulaki","year":"2007","journal-title":"Eur Heart J"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.2147\/jir.s335671","article-title":"Albumin\/globulin ratio as yin-yang in rheumatoid arthritis and its correlation to inflamm-aging cytokines","volume":"14","author":"Chen","year":"2021","journal-title":"J Inflammation Res"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.121.318535","article-title":"Epidemiology of peripheral artery disease and polyvascular disease","volume":"128","author":"Aday","year":"2021","journal-title":"Circ Res"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2008.04.042","article-title":"Endogenous peroxynitrite modulates PGHS-1-dependent thromboxane A2 formation and aggregation in human platelets","volume":"45","author":"Schildknecht","year":"2008","journal-title":"Free Radic Biol Med"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-02-333203","article-title":"The antifibrinolytic function of factor XIII is exclusively expressed through \u03b12-antiplasmin cross-linking","volume":"117","author":"Fraser","year":"2011","journal-title":"Blood"},{"key":"B35","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jacc.2019.05.049","article-title":"Cigarette smoking, smoking cessation, and long-term risk of 3 major atherosclerotic diseases","volume":"74","author":"Ding","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-11-201106070-00003","article-title":"Smoking, smoking cessation, [corrected] and risk for symptomatic peripheral artery disease in women: a cohort study","volume":"154","author":"Conen","year":"2011","journal-title":"Ann Intern Med"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.5603\/kp.a2015.0178","article-title":"Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study","volume":"74","author":"Maroszy\u0144ska-Dmoch","year":"2016","journal-title":"Kardiol Pol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2015-133269","article-title":"A retrospective cross-sectional study on the association between tobacco smoking and incidence of ST-segment elevation myocardial infarction and cardiovascular risk factors","volume":"91","author":"Steele","year":"2015","journal-title":"Postgrad Med J"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.02.045","article-title":"Effect of smoking on outcomes of primary PCI in patients with STEMI","volume":"75","author":"Redfors","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.11.011","article-title":"Prevalence and association between risk factors, stroke subtypes, and abnormal ankle brachial index in acute ischemic stroke","volume":"21","author":"Ratanakorn","year":"2012","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.121.034388","article-title":"Inflammation and stroke risk: a new target for prevention","volume":"52","author":"Kelly","year":"2021","journal-title":"Stroke"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1839770\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:51:08Z","timestamp":1779943868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1839770\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":41,"alternative-id":["10.3389\/fendo.2026.1839770"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1839770","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"1839770"}}