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...

Full description

Saved in:
Bibliographic Details
Main Authors: Taotao Zhang, Peiqian Liu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Preventive Medicine Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525001408
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849716331171020800
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
work_keys_str_mv AT taotaozhang associationofhemoglobinalbuminlymphocyteandplateletscorewithallcauseandcardiovascularmortalityinadultswithdiabetesorprediabetesresultsfromnhanes20052018
AT peiqianliu associationofhemoglobinalbuminlymphocyteandplateletscorewithallcauseandcardiovascularmortalityinadultswithdiabetesorprediabetesresultsfromnhanes20052018