Association of hemoglobin, albumin, lymphocyte and platelet (HALP) score with dyslipidemia in adults: NHANES 2005–2018
Ying Li, Jinshen He, Yuzhe HuangPurpose
This paper aims to examine associations of the hemoglobin, albumin, lymphocyte and platelet (HALP) score with dyslipidemia, hypercholesterolemia, and hypertriglyceridemia in a nationally representative sample of US adults.
Design/methodology/approach
Data from NHANES 2005–2018 were analyzed. HALP was calculated from hemoglobin, albumin, lymphocyte count and platelet count. Survey-weighted logistic regression incorporated fasting subsample weights, strata and primary sampling units. Natural cubic splines assessed continuous dose-response patterns. Fully adjusted models excluded the four HALP components, and multiple imputation was used as a sensitivity analysis.
Findings
Among 11,350 complete-case participants, fully adjusted odds ratios comparing HALP quartile 4 with quartile 1 were 1.46 (95% confidence interval [CI] 1.23–1.74) for dyslipidemia, 1.31 (95% CI 1.05–1.65) for hypercholesterolemia, and 1.67 (95% CI 1.30–2.15) for hypertriglyceridemia. Dyslipidemia and hypertriglyceridemia were also associated with quartile 3, whereas the hypercholesterolemia association was weaker and significant only in quartile 4. Natural cubic splines showed nonlinear dose-response associations for all three outcomes. The cross-sectional findings do not establish causality or clinical predictive utility.
Research limitations/implications
Even with attempts to control for interfering variables as much as possible, the influence of other potential covariates remains. Attempts to control interfering variables are made, yet the influence of other potential covariates continues. The exclusion of numerous participants due to incomplete data or unmet inclusion criteria may have led to selection bias, impacting the generalizability of the findings. This exclusion could affect the generalizability of the results to broader populations.
Practical implications
The investigation may provide an understanding of causal association between HALP score and dyslipidemia. Using the NHANES database, the research selected a typical group of individuals through detailed multi-stage sampling methods. The four parts of HALP score are also quantifiable and provide considerable clinical benefits. HALP score consists of four parts that are easy to measure and offer substantial benefits in a clinical setting.
Social implications
Robust statistical methods were used, such as adjusting for confounding variables, to minimize potential bias. Future investigations with larger and more inclusive datasets are recommended to authenticate these conclusions and enhance their applicability to diverse populations.
Originality/value
This study provides nationally representative, survey-weighted evidence comparing HALP associations across three lipid outcomes and characterizing their continuous dose-response patterns. Longitudinal and externally validated studies are required before clinical application.