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Liu Y, Jin X, Jia W, Guan X, Wu H, Li J, Cui M, Zhang H, Wei L, Qi X. Association of fibrinogen/albumin ratio and Castelli risk index 2 (CRI-2=LDL-C/HDL-C) with severity of coronary artery lesions in different glucose metabolism states. Endocrine 2025:10.1007/s12020-025-04259-y. [PMID: 40381131 DOI: 10.1007/s12020-025-04259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Accepted: 04/27/2025] [Indexed: 05/19/2025]
Abstract
BACKGROUND The fibrinogen to albumin ratio (FAR) is a novel inflammatory indicator correlating with the severity of coronary artery disease (CAD). An indicator of atherosclerosis is the Castelli Risk Index 2 (CRI-2=LDL-C/HDL-C). Yet, little research has focused on the link between both of indicators and CAD in different glucose metabolic states. Thus, this study aimed to investigate the association between FAR, CRI-2, and the severity of coronary artery lesions in patients with CAD in different glucose metabolic states. METHOD In this investigation, coronary angiography was performed about 2825 individuals suffering from symptomatic CAD at Tianjin Union Medical Center from 2016-2023.The number of stenotic arteries in the coronary arteries was counted. The Gensini scores were taken into account. Normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM) were the three categories of glucose status according to the WHO diabetes guidelines. Patients were also divided into FAR index and CRI-2 quartiles to look into the link between FAR index and CRI-2 and coronary artery lesions in CAD patients with different glucose metabolic states. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive value of the FAR index and CRI-2 for coronary artery lesions. RESULT According to logistic regression analysis, the FAR index and CRI-2 were statistically associated with coronary artery disease (P < 0.05). The FAR index was linked with severity of coronary artery lesions regardless of glucose metabolism states (P < 0.05). The CRI-2 was strongly linked with severity of coronary artery lesions in both NGR and DM status (P < 0.05). Yet, there was no statistical significance in Pre-DM states (P > 0.05). The FAR index and CRI-2 exhibited higher regions underneath the ROC curve in forecasting severity of coronary artery lesions. CONCLUSION The FAR index and CRI-2 were significantly associated with severity of coronary artery lesions in different glucose metabolic states. FAR index and CRI-2 have predictive value for coronary artery lesions.
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Affiliation(s)
- Yue Liu
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
| | - Xiandu Jin
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Wenjun Jia
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
| | - Xiuju Guan
- School of Graduate Studies, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hao Wu
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Jiao Li
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
| | - Min Cui
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Hanmo Zhang
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Liping Wei
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China.
| | - Xin Qi
- Department of Cardiology, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, China.
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Demir N, Gökmen İ, Sağdıç Karateke Y, İlhan A, Yıldız F, Bayır Garbioğlu D, Yıldız B. HALP score as a prognostic marker for overall survival in advanced pancreatic cancer. Front Oncol 2025; 15:1542463. [PMID: 40365347 PMCID: PMC12069060 DOI: 10.3389/fonc.2025.1542463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Accepted: 03/31/2025] [Indexed: 05/15/2025] Open
Abstract
Introduction Pancreatic cancer is the leading cause of cancer-related deaths worldwide and most of the patients diagnosed at an advanced stage. Clinicians need simple, effective, and repeatable tools to predict the prognosis. This study aimed to evaluate the relationship between the HALP score and prognosis in patients with advanced pancreatic cancer. Methods Patients diagnosed with advanced pancreatic cancer at three centers in Turkey between 2009 and 2023 were included in this retrospective study. Demographic features, blood parameters, treatment received, treatment responses, and survival were recorded. Results 227 patients were included in the study. The median overall survival (OS) for the entire cohort was 10.4 months. The median OS was 8.7 months in the low-HALP group and 11.2 months in the high- HALP group. Patients in the low-HALP group had a significantly shorter median OS than those in the high-HALP group (log rank p=0.001). Conclusion The HALP score is a reliable and practical tool that can be utilized in clinical practice to predict prognosis in patients with advanced pancreatic cancer.
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Affiliation(s)
- Nazan Demir
- Department of Medical Oncology, Sultan I. Murat Public Hospital, Edirne, Türkiye
| | - İvo Gökmen
- Department of Medical Oncology, Mehmet Akif Ersoy Public Hospital, Çanakkale, Türkiye
| | - Yasemin Sağdıç Karateke
- Department of Medical Oncology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - Ayşegül İlhan
- Department of Medical Oncology, Etlik City Hospital, Ankara, Türkiye
| | - Fatih Yıldız
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Türkiye
| | - Duygu Bayır Garbioğlu
- Department of Medical Oncology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Bülent Yıldız
- Department of Medical Oncology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
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Li H, Zhou Y, Zhang X, Yao R, Li N. The relationship between hemoglobin, albumin, lymphocyte, and platelet (HALP) score and 28-day mortality in patients with sepsis: a retrospective analysis of the MIMIC-IV database. BMC Infect Dis 2025; 25:333. [PMID: 40065235 PMCID: PMC11892195 DOI: 10.1186/s12879-025-10739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Accepted: 03/03/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND In recent years, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score has emerged as a potential marker of immunological and nutritional status. This study aimed to evaluate the association between the HALP score and prognosis in patients with sepsis. METHODS This retrospective cohort study analyzed sepsis patients using clinical data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were classified into Low-score and High-score groups. Confounding factors were controlled through propensity score matching (PSM) analysis. The primary outcome was 28-day mortality in individuals with sepsis. Survival probabilities between groups were compared using Kaplan-Meier curves. Multivariable Cox regression analysis and a smoothing spline fitting curve were employed to investigate the relationship between the HALP score and 28-day mortality. ROC curve analysis and subgroup analysis were performed to evaluate the predictive ability of the HALP score and its components. RESULTS A total of 2,968 sepsis patients were included, with 809 (27.26%) deaths within 28 days. After PSM analysis, the High-score group had a 24% lower risk of 28-day mortality compared to the Low-score group (HR, 0.76; 95% CI, 0.64-0.91). In the unmatched cohort, the multivariable Cox regression model also indicated that the High-score group had a lower 28-day mortality risk (HR, 0.78; 95% CI, 0.67-0.91). The smoothing spline fitting curve showed a nonlinear relationship between the HALP score and 28-day mortality, with an inflection point at 24.69. When the HALP score was below 24.69, an increase of one point in the HALP score was associated with a 2% reduction in 28-day mortality (HR, 0.98; 95% CI, 0.97-0.99). The HALP score provided incremental predictive value for 28-day mortality when combined with the SOFA score. Albumin was identified as the most influential component of the HALP score. CONCLUSION Among patients with sepsis, the HALP score exhibited a nonlinear relationship with 28-day mortality. An elevated HALP score is associated with reduced 28-day, 90-day, 360-day, and in-hospital mortality among sepsis patients.
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Affiliation(s)
- Huan Li
- Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China
- Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, China
| | - Yiran Zhou
- Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China
- Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Xinying Zhang
- Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China
- Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China
| | - Run Yao
- Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China.
- Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China.
| | - Ning Li
- Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, China.
- Clinical Transfusion Research Centre, Xiangya Hospital, Central South University, Changsha, China.
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Tortum F, Tekin E, Gur A. Predictive value of the Hemoglobin, Albumin, Lymphocyte and Platelet score for mortality in geriatric patients presenting to the emergency department. Geriatr Gerontol Int 2025; 25:387-391. [PMID: 39838526 PMCID: PMC11911145 DOI: 10.1111/ggi.15082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 11/26/2024] [Accepted: 01/06/2025] [Indexed: 01/23/2025]
Abstract
AIM The Hemoglobin, Albumin, Lymphocyte and Platelet (HALP) score, calculated as hemoglobin × albumin × lymphocytes / platelets, serves as a novel biomarker that can provide insights into a patient's nutritional status, anemia status and inflammatory processes. This study aimed to investigate the predictive value of the HALP score for mortality among geriatric patients presenting to the emergency department. METHODS This retrospective study was carried out at the emergency department of a tertiary hospital. Patients aged ≥65 years who presented to the emergency department between 1 January 2018 and 1 January 2024 were included in the study. A total of 62 262 patients who visited our emergency department were enrolled. Patient data, including hemoglobin, albumin, lymphocyte and platelet values; age; sex, the reason for hospital presentation; and outcome (mortality or discharge) were obtained from electronic medical records. HALP scores were calculated for the patients, and statistical analyses were carried out. RESULTS Of the patients, 32 410 were men, and the mean age was 73 years. Within this cohort, in-hospital mortality occurred in 3093 of the patients. The HALP score was significantly lower in patients who died compared with those who were discharged (P < 0.001). CONCLUSION Due to its cost-effectiveness and ease of calculation, the HALP score appears to be more feasible in predicting mortality in the emergency department compared with other scoring systems. Geriatr Gerontol Int 2025; 25: 387-391.
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Affiliation(s)
- Fatma Tortum
- Department of Emergency Medicine, School of MedicineAtaturk UniversityErzurumTurkey
| | - Erdal Tekin
- Department of Emergency Medicine, School of MedicineAtaturk UniversityErzurumTurkey
| | - Ali Gur
- Department of Emergency Medicine, School of MedicineAtaturk UniversityErzurumTurkey
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Keskin Y, Sevinç H, Hazinedaroğlu SM, Morkavuk ŞB, Ersöz Ş. Predictive Utility of the HALP and Modified HALP Score for the Assessment of Operative Complications in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis. Diagnostics (Basel) 2025; 15:152. [PMID: 39857037 PMCID: PMC11763695 DOI: 10.3390/diagnostics15020152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2024] [Revised: 12/30/2024] [Accepted: 12/31/2024] [Indexed: 01/27/2025] Open
Abstract
Background and Objectives: The aim of the present study was to calculate HALP and modified HALP scores for patients diagnosed with acute cholecystitis (AC) and to determine the predictive utility of these scores for surgical timing and morbidity in patients who underwent surgery for AC. Materials and Methods: This study included data from 641 patients who underwent surgery for AC between January 2010 and May 2023. The HALP score was calculated using the formula hemoglobin (g/L) × albumin (g/L) × lymphocyte (109/L)/platelets (109/L). The modified HALP score was calculated using the formula hemoglobin (g/L) × albumin (g/L) × lymphocyte (109/L) × platelets (109/L). Results: The mean HALP score was 46.81, and the mean modified HALP score was 2,758,401.21. Laparoscopic cholecystectomy (LC) was successfully completed in 582 (90.8%) patients. When examining the relationship between HALP and modified HALP scores and the procedure type, a statistically significant difference was found in the distribution of median HALP and modified HALP scores between the LC and laparoscopic and open cholecystectomy (LTOC) groups. For patients with a HALP score < 34.43 and modified HALP score < 2,077,019, the likelihood of conversion to open surgery increased, with a sensitivity of 65.5% vs. 58.8% and a specificity of 66.1% vs. 59.3%. In patients who underwent surgery, there was a significant difference in the LTOC between the HALP score and modified HALP score cut-off groups (p < 0.001 and, p = 0.007). Conclusions: Evaluation of the HALP score is a promising and valuable assessment method for designing appropriate treatment and management strategies for patients with AC.
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Affiliation(s)
- Yasemin Keskin
- Department of General Surgery, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey;
| | - Hakan Sevinç
- Department of General Surgery, Ankara University School of Medicine, Ankara 06200, Turkey; (H.S.); (S.M.H.)
| | | | - Şevket Barış Morkavuk
- Department of Surgical Oncology, Health Sciences University Gülhane Training and Research Hospital, Ankara 06018, Turkey;
| | - Şiyar Ersöz
- Department of General Surgery, Ankara University School of Medicine, Ankara 06200, Turkey; (H.S.); (S.M.H.)
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Chen D, Chen J, Zhou Q, Mi H, Liu G. Association of the hemoglobin, albumin, lymphocyte, and platelet score with the risk of Erectile dysfunction: a cross-sectional study. Sci Rep 2024; 14:15869. [PMID: 38982136 PMCID: PMC11233679 DOI: 10.1038/s41598-024-66667-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 07/03/2024] [Indexed: 07/11/2024] Open
Abstract
Erectile dysfunction (ED) is related to nutritional and inflammatory factors. The hemoglobin, albumin, lymphocyte, and platelet score (HALP), a new index reflecting the nutritional and inflammatory status, has been associated with a higher risk of diabetic retinopathy, particularly at lower values (≤ 42.9). However, studies focusing on the relationship between HALP and ED risk are scarce. Hence, this study aimed to investigate the association between HALP and ED. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. Based on self-reported data, participants were classified into either the ED group or the non-ED group. Next, the HALP score was categorized into four quartiles (Q1-4). Weighted multivariate regression analysis was performed to assess the relationship between categorical HALP and ED risk. Additionally, restricted cubic spline (RCS) analysis was conducted to examine the association between continuous HALP scores and ED risk. Furthermore, subgroup analyses were conducted to examine the association between categorical HALP and the risk of ED based on age, as well as the status of hypertension, diabetes and cardiovascular disease. Finally, a mediation analysis was carried out to investigate the mediating effect of HALP and related parameters on the association between urinary cobalt levels and ED. Initially, the data of 21,161 participants were collected. After implementing the inclusion and exclusion criteria, 3406 participants were included in the final analyses. Weighted multivariate regression analysis demonstrated that the Q4 HALP group was associated with a lower risk of ED (OR 0.96, 95% confidence intervals 0.92-1.00, P = 0.037). Meanwhile, RCS analysis showed that HALP was nonlinearly associated with the risk of ED. In addition, subgroup analyses demonstrated that participants in the Q3/4 HALP group had a significantly lower ED risk than those in the Q1 group among patients aged ≥ 50 years, as well as those with hypertension and diabetes. Lastly, mediation analysis revealed that HALP and its associated parameters had a marginal average causal mediation effect on the relationship between urinary cobalt levels and ED risk (P > 0.05). In US adults, high HALP scores were correlated with a lower risk of ED. The relationship was more pronounced in participants aged ≥ 50 years with hypertension and diabetes. Furthermore, HALP and its parameters may not mediate the association between urinary cobalt levels and ED risk.
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Affiliation(s)
- Di Chen
- The Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinji Chen
- The Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiufeng Zhou
- The 924th Hospital of Chinese PLA Joint Service Support Force, Guilin, China
| | - Hua Mi
- The Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
| | - Gang Liu
- The Department of Urology, Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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Valero C, León X, Quer M. Host-related indexes in head and neck cancer. Curr Opin Otolaryngol Head Neck Surg 2024; 32:113-117. [PMID: 38116851 DOI: 10.1097/moo.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Peripheral blood host-related indexes have been widely studied in cancer patients. Several authors have shown the prognostic capacity of these indexes in head and neck cancer. Therefore, there has been an increasing interest in this topic recently. RECENT FINDINGS The main variables analyzed and used to create these host-related indexes are peripheral blood leukocytes - including neutrophils, monocytes and lymphocytes - albumin and hemoglobin levels. Other factors with proven prognostic capacity in some studies are: platelets, C-reactive protein, and BMI. Among all the combined indexes, the neutrophil-to-lymphocyte ratio has been the most accepted and used worldwide. Nonetheless, there are other indexes which group multiple of these factors that have shown better prognostic capacity, and are promising in the near future. SUMMARY Host-related indexes are ideal biomarkers to be used on our daily-basis. There is enough evidence to start considering them when assessing patients with head and neck cancer.
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Affiliation(s)
- Cristina Valero
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
| | - Xavier León
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid
- UVIC. Universitat Central de Catalunya, Vic, Spain
| | - Miquel Quer
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid
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