Association between hemoglobin, albumin, lymphocyte, and platelet score and all-cause and cardiovascular mortality among population with diabetes: Evidence from the NHANES 2003-2016.

Introduction: This study investigated the relationship between the Hemoglobin, Albumin, Lymphocyte, and Platelets (HALP) score and all-cause and cardiovascular mortality risk in diabetes patients.

Methods: An analysis included 2154 individuals with diabetes from the 2003-2016 National Health and Nutrition Examination Survey (NHANES), with mortality data tracked until December 31, 2019. Cox regression models were adopted to evaluate the association of HALP score with mortality. The nonlinear relationship was examined using restricted cubic splines (RCS), and a two-segmented Cox proportional risk model analyzed data around identified threshold values.

Results: During a median follow-up of 90 months, 565 (26.23 %) deaths occurred, of which 166 (7.71 %) caused by cardiovascular disease. In the Cox regression models, participants in the highest quartile of HALP score had lower risks of all-cause mortality (HR = 0.59,95 % CI:0.43-0.83, p = 0.002) and cardiovascular mortality (HR = 0.38,95 % CI:0.22-0.66, p < 0.001) compared to the lowest quartile. Based on the restricted cubic splines (RCS) curve, a L-shaped relationship was found, with thresholds of 49.81 for all-cause and 48.78 for cardiovascular mortality. HALP scores below these thresholds were associated with increased mortality (p < 0.001).

Conclusion: HALP score may serve as a valuable clinical indicator for predicting mortality risk in diabetes patients.