Can the HALP Score Be Predictive in Different Clinical Stages of Diabetes?
HALP Score As Diabetes Stage Predictor
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DOI:
https://doi.org/10.5281/zenodo.14740592Keywords:
HALP Score, Diabetes Mellitus, Biological MarkersAbstract
Background: The Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score is a novel biomarker integrating routine laboratory parameters to assess a patient’s immune nutritional status. Integrating the HALP score into routine diabetes management could help stratify patients based on their risk of complications and guide treatment strategies accordingly. For example, a patient with a low HALP score presenting to a clinic might be flagged for immediate nutritional support and more frequent monitoring of inflammatory markers. In contrast, those with higher scores could follow standard care protocols. This study investigated the potential of the HALP score as a prognostic biomarker by evaluating its correlation with clinical and laboratory parameters between diabetic patients and healthy controls.
Method: A total of 133 participants, comprising 96 diabetic patients and 37 healthy individuals were included in the study. Participants were divided into four groups: control (n=37), prediabetes (n=37), diabetes (=30), and complicated diabetes (n=29). Comprehensive demographic, clinical, and laboratory data were collected, and the HALP score was calculated as hemoglobin × albumin × lymphocyte count/platelet count. The HALP score was calculated and its relationship with various parameters was analyzed using Spearman correlation and ROC analysis.
Results: The study found significant differences in HALP scores between the groups; the highest score was observed in the prediabetes group at 49 (18-101), while the lowest score was in the complicated diabetes group at 39 (13-101). There was no significant difference in HALP scores between genders. A weak negative correlation was found between age and HALP score. Significant correlations were identified between HALP scores and parameters such as albumin, hemoglobin, lymphocytes, BUN, CRP, and HbA1c. ROC analysis demonstrated high diagnostic accuracy of low HALP scores in identifying complicated diabetes, with AUC> 0.7 (p< 0.003). Among comorbidities, only the anemic group had a significantly lower HALP score of 28 compared to 50 in the non-anemic group (p= 0.026).
Conclusion: This study underscores the HALP score’s potential as a powerful prognostic biomarker for diabetes, offering a cost-effective and readily accessible tool for clinical stratification. Its significant correlations with disease severity, inflammatory markers, and nutritional parameters position it as an indispensable addition to the diagnostic arsenal for diabetes management. Future research, including longitudinal studies, is warranted to validate these findings and establish standardized clinical applications.
References
Farag CM, Antar R, Akosman S, Ng M, Whalen MJ. What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP’s prognostic ability in different cancer types. Oncotarget. 2023;14:153-172. Published 2023 Feb 25. doi:10.18632/oncotarget.28367
Guo Y, Shi D, Zhang J, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score is a Novel Significant Prognostic Factor for Patients with Metastatic Prostate Cancer Undergoing Cytoreductive Radical Prostatectomy. J Cancer. 2019;10(1):81-91. Published 2019 Jan 1. doi:10.7150/jca.27210
Guijosa A., Calderillo-Ruiz G., Munoz Montano W. R., et al. HALP index prognostic significance for colon cancer patients in a Hispanic-based population. Journal of Clinical Oncology. 2022;40(16) doi: 10.1200/ JCO.2022.40.16_suppl.e15521.e15521
Vlatka P, Marko L, Stefan M, Dorian L. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel prognostic factor for patients with diffuse large B-cell lymphoma. J Cancer Res Ther. 2022;18(3):725-732. doi:10.4103/jcrt.jcrt_174_21
Feng JF, Wang L, Yang X. The preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) score is a useful predictor in patients with resectable esophageal squamous cell carcinoma. Bosn J Basic Med Sci. 2021;21(6):773-781. Published 2021 Dec 1. doi:10.17305/ bjbms.2021.5666
Gao X, Lin B, Lin Q, et al. A HALP score-based prediction model for survival of patients with the upper tract urothelial carcinoma undergoing radical nephroureterectomy. Bosn J Basic Med Sci. 2022;22(2):280-290. Published 2022 Apr 1. doi:10.17305/bjbms.2021.6543
Akgül, GG. The Relationship Between the HALP Score and Gastric Cancer Prognosis: HALP Score in Gastric Cancer. J Eur Int Med Prof. 2023;1(4):156:161. Doi:10.5281/zenodo.10019807
Tian M, Li Y, Wang X, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Is Associated With Poor Outcome of Acute Ischemic Stroke. Front Neurol. 2021;11:610318. Published 2021 Jan 12. doi:10.3389/fneur.2020.610318
Kocaoglu S, Alatli T. The Efficiency of the HALP Score and the Modified HALP Score in Predicting Mortality in Patients with Acute Heart Failure Presenting to the Emergency Department. J Coll Physicians Surg Pak. 2022;32(6):706-711. doi:10.29271/jcpsp.2022.06.706
Antar R, Farag C, Xu V, Drouaud A, Gordon O, Whalen MJ. Evaluating the baseline hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the United States adult population and comorbidities: an analysis of the NHANES. Front Nutr. 2023;10:1206958. Published 2023 May 18. doi:10.3389/fnut.2023.1206958
Alshuweishi Y, Basudan AM, Alfaifi M, Daghistani H, Alfhili MA. Association of the HALP Score with Dyslipidemia: A Large, Nationwide Retrospective Study. Medicina (Kaunas). 2023;59(11):2002. Published 2023 Nov 14. doi:10.3390/medicina59112002
Zheng Y, Huang Y, Li H. Hemoglobin albumin lymphocyte and platelet score and all-cause mortality in coronary heart disease: a retrospective cohort study of NHANES database. Front Cardiovasc Med. 2023;10:1241217. Published 2023 Nov 13. doi:10.3389/ fcvm.2023.1241217
Zhang F, Li L, Shi T, Liu Y, Xie J, Yu L. The hemoglobin, albumin, lymphocyte, and platelet (HALP) is a potent indicator for the prognosis in hemodialysis patients. Medicine (Baltimore). 2023;102(19):e33650. doi:10.1097/MD.
Zhang X, et al. Prognostic value of HALP score in patients with diabetic complications. J Diabetes Res. 2023.
Cheng H, et al. Correlation of HALP score with nutritional and inflammatory status in diabetic patients. Clin Diabetes Endocrinol. 2022;8(1):12-19.
Wang Y, et al. Predictive value of HALP score for diabetic complications. Diabetes Metab. 2021;47(2):101-110.
Ding R, Zeng Y, Wei Z, et al. The L-shape relationship between hemoglobin, albumin, lymphocyte, platelet score and the risk of diabetic retinopathy in the US population. Front Endocrinol (Lausanne). 2024;15:1356929. Published 2024 May 10. doi:10.3389/ fendo.2024.1356929
Lee J, et al. Influence of inflammatory and nutritional factors on HALP scores in diabetic patients. J Clin Endocrinol Metab. 2020;105(6):1772-1780.
Kim S, et al. HALP scores and cardiovascular risk in diabetic patients. Cardiovasc Diabetol. 2019;18(1):45-53.
Miller B, Chen L, Santos A. Emerging biomarkers combined with HALP scores for enhanced risk prediction in diabetes. J Diabetes Sci Technol. 2022;16(2):284-295. doi:10.1177/19322968221080928.
Taylor M, Nguyen A, Blake R. Multi-biomarker strategies incorporating HALP scores for diabetes risk stratification. Endocr Res. 2023;48(1):77-89. doi:10.1080/074358023.
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