Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Variation Among Normoglycemia, Prediabetes, and Diabetes.

Abstract

Objective: The association between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and mortality among individuals with diabetes or prediabetes has not been clearly established. The aim of the present study was to compare the HALP score of individuals with disglycemic status in a tertiary care hospital.

Methods: A retrospective analysis was conducted on 3,545 participants (2022-2024) from the Future Lab Pioneer database. Participants were classified as type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), or normoglycemic. HALP was calculated and compared by Mann-Whitney U or Kruskal-Wallis tests. Linear regression assessed group differences and correlations with glycemic and metabolic indicators, while principal component analysis (PCA) explored key laboratory contributors to glycemic variation.

Results: HALP scores varied by age and sex, with males showing higher values (p<0.0001). Higher HALP correlated inversely with HbA1c (p<0.0001) but not fasting blood glucose. Participants in the highest HALP quartile had higher hemoglobin, albumin, and lymphocyte counts and lower platelet and WBC counts. PCA highlighted inflammation-related markers, particularly WBC and neutrophils, as major contributors to glycemic variability, emphasizing systemic inflammation's role in dysglycemia.

Conclusion: HALP reflects immunonutritional status and systemic inflammatory burden and shows associations with long-term glycemic status. Owing to its simplicity, low cost, and derivation from routine laboratory parameters, HALP may serve as a complementary index for characterizing metabolic and inflammatory profiles across glycemic categories, particularly in younger males. However, prospective longitudinal studies are required to determine whether HALP has independent predictive value for dysglycemia in clinical practice.