Association of hemoglobin, albumin, lymphocyte, and platelet score with all-cause and cardiovascular mortality in adults with diabetes or prediabetes: Results from NHANES 2005–2018
Objective: The relationship between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and mortality in patients with diabetes/prediabetes remains uncertain. This study aimed to evaluate linear and non-linear associations between the HALP score and all-cause and cardiovascular mortality...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335525001408 |
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| Summary: | Objective: The relationship between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and mortality in patients with diabetes/prediabetes remains uncertain. This study aimed to evaluate linear and non-linear associations between the HALP score and all-cause and cardiovascular mortality in this population and identify potential clinically relevant thresholds. Methods: We analyzed data from 19,350 United States adults with diabetes/prediabetes using two linked datasets: the National Health and Nutrition Examination Survey (NHANES, 2005–2018) and mortality records from the National Death Index (NDI), with follow-up through December 31, 2019. Kaplan-Meier survival curves, Cox proportional hazards models, and restricted cubic splines (RCS) were used to evaluate the HALP score and mortality associations. Results: Kaplan-Meier analysis revealed the highest all-cause mortality in Q1, the lowest all-cause mortality in Q3, and the lowest cardiovascular mortality in Q4 (p-value <0.0001). Cox regression analysis demonstrated significantly reduced risks of all-cause mortality (HR 0.64, 95 % CI 0.58, 0.73) and cardiovascular mortality (HR 0.58, 95 % CI 0.42, 0.82) in Q4 compared to Q1. RCS identified an L-shaped association between the HALP score and mortality, with inflection points at 42.29 (all-cause) and 39.98 (cardiovascular). Conclusion: An L-shaped association between the HALP score and both all-cause and cardiovascular mortality in participants with diabetes mellitus or prediabetes. |
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| ISSN: | 2211-3355 |