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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| Language: | English |
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Elsevier
2025-06-01
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| Series: | Preventive Medicine Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335525001408 |
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| author | Taotao Zhang Peiqian Liu |
| author_facet | Taotao Zhang Peiqian Liu |
| author_sort | Taotao Zhang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-35b88949aa2d419888d4f13aceebf7ee |
| institution | DOAJ |
| issn | 2211-3355 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj-art-35b88949aa2d419888d4f13aceebf7ee2025-08-20T03:13:03ZengElsevierPreventive Medicine Reports2211-33552025-06-015410310110.1016/j.pmedr.2025.103101Association of hemoglobin, albumin, lymphocyte, and platelet score with all-cause and cardiovascular mortality in adults with diabetes or prediabetes: Results from NHANES 2005–2018Taotao Zhang0Peiqian Liu1Corresponding author at: No.288, Zishun Road, Fengyang County, Chuzhou City, Anhui Province, China.; Department of Endocrinology, Fengyang People's Hospital, Fengyang, ChinaDepartment of Endocrinology, Fengyang People's Hospital, Fengyang, ChinaObjective: 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.http://www.sciencedirect.com/science/article/pii/S2211335525001408Hemoglobin, albumin, lymphocyte, and platelet scoreAll-cause mortalityCardiovascular mortalityDiabetesPrediabetes |
| spellingShingle | Taotao Zhang Peiqian Liu 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 Preventive Medicine Reports Hemoglobin, albumin, lymphocyte, and platelet score All-cause mortality Cardiovascular mortality Diabetes Prediabetes |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Hemoglobin, albumin, lymphocyte, and platelet score All-cause mortality Cardiovascular mortality Diabetes Prediabetes |
| url | http://www.sciencedirect.com/science/article/pii/S2211335525001408 |
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