Association of aerobic exercise habits with higher albumin-globulin ratio and lower cellular immune-inflammatory markers: implication of the preventive effect of aerobic exercise on atherosclerotic cardiovascular disease.

Abstract

This correspondence identifies irreconcilable contradictions in Tani et al.'s article (Heart Vessels. 2025;40:509-522) that critically undermine its conclusions. Key concerns include paradoxical relationships between smoking and albumin-globulin ratio (AGR), discordant liver enzyme patterns, and inconsistent inflammatory marker responses. Alternative mechanisms involving humoral suppression and hepatic adaptation better explain the findings. The study's cross-sectional design cannot resolve these discrepancies, necessitating longitudinal validation before clinical interpretation.