Association between hemoglobin albumin lymphocyte and platelet (HALP) score and psoriasis: Evidence from NHANES.

Background: The HALP (hemoglobin, albumin, lymphocyte, and platelet) score is a novel indicator that measures systemic inflammation and nutritional status. This study aimed to investigate the association between HALP score and psoriasis in US participants.

Methods: Data from the National Health and Nutrition Examination Survey (NHANES) (2003-2006, 2009-2014) were utilized. HALP score was calculated as hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/platelets (/L). The study participants were divided into 4 groups based on quartiles cutoffs of the HALP score. Multivariate logistic regression analysis was used to explore the relationship between the HALP score and psoriasis. Restricted cubic spline analysis, and subgroup analysis were used to investigate relationships between HALP score and psoriasis.

Results: A total of 23,389 participants were included, with 613 (2.62 %) having psoriasis. HALP scores ranged from 0.381 to 21.152, with quartile cutoffs of Q1: ≤3.87, Q2: 3.87-5.09, Q3: 5.09-6.63, and Q4: ≥6.63. The relationship between HALP score and psoriasis was linear (P for nonlinear = 0.4612). Each unit increase in HALP score was associated with 5 % lower odds of psoriasis (OR = 0.95, 95 %CI: 0.91-0.99, P = 0.022). Participants in the third and fourth HALP quartiles had significantly lower odds of psoriasis (OR = 0.76; 95 % CI: 0.60-0.98; OR = 0.71; 95 % CI: 0.54-0.92, respectively) compared with the first quartile, representing a clinically meaningful 29 % risk reduction that could inform psoriasis risk stratification strategies. Similar results were seen in female, non-Hispanic White, without history of malignancy, CVD, and diabetes.

Conclusion: Higher HALP score was independently associated with a clinically meaningful decreased risk of psoriasis. The substantial risk reduction observed suggests that HALP score, derived from routine laboratory tests, could serve as a practical and cost-effective biomarker for psoriasis risk stratification in clinical practice.