血红蛋白、白蛋白、淋巴细胞和血小板评分与一般人群中脑血管、心血管和全因死亡率的相关性：来自 NHANES 1999-2018 的结果。
Association of hemoglobin, albumin, lymphocyte, and platelet score with risk of cerebrovascular, cardiovascular, and all-cause mortality in the general population: results from the NHANES 1999-2018.
机构信息
Department of Neurology, Deqing People's Hospital (Deqing Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University), Huzhou, China.
Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
出版信息
Front Endocrinol (Lausanne). 2023 Jun 23;14:1173399. doi: 10.3389/fendo.2023.1173399. eCollection 2023.
BACKGROUND AND AIMS
Cardiovascular and cerebrovascular disease (CCDs) contribute to leading causes of morbidity and mortality in the United States of America (USA). Hemoglobin, albumin, lymphocyte, and platelet (HALP) score, a simple and convenient indicator, could reflect the combination of inflammation and nutritional status. This study was undertaken to evaluate the associations between HALP score and risk of cardiovascular, cerebrovascular, and all-cause mortality in the general population from the National Health and Nutrition Examination Survey (NHANES) 1999-2018.
METHODS
We identified 21,578 participants during the 1999-2018 cycles of the NHANES in this research. HALP score was calculated as hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L)/platelets (/L). Outcomes were cerebrovascular, cardiovascular, and all-cause mortality determined by the NHANES-linked National Death Index record and followed until 31 December 2019. Survey-weighted Cox regression, restricted cubic spline analysis, and subgroup analysis were applied to investigate relationships between HALP score and risk of mortality.
RESULTS
This cohort study comprised 49.2% male and 50.8% female, of which the median age was 47 years old. In multivariate survey-weighted Cox regression adjusting for all confounders, compared with participants with low HALP scores, participants with highest HALP score had a lower risk of all-cause mortality (adjusted HR:0.80, 95% CI: 0.73, 0.89, < 0.0001) and cardiovascular mortality (adjusted HR:0.61, 95% CI: 0.50, 0.75, < 0.0001), and mediate HALP score had the lowest risk of all-cause mortality (adjusted HR:0.68, 95% CI: 0.62, 0.75, < 0.0001) and cardiovascular mortality (adjusted HR:0.60, 95% CI: 0.48, 0.75, < 0.0001). Restricted cubic spline analysis showed a non-linear relationship between HALP score and cardiovascular and all-cause mortality (all values <0.001).
CONCLUSION
HALP score was independently associated with risk of cardiovascular and all-cause mortality, but not cerebrovascular mortality.
背景和目的
心血管疾病和脑血管疾病（CCDs）是导致美国（USA）发病率和死亡率的主要原因。血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分是一种简单方便的指标，可反映炎症和营养状况的综合情况。本研究旨在评估国民健康和营养调查（NHANES）1999-2018 年期间，一般人群的 HALP 评分与心血管、脑血管和全因死亡率之间的关系。
方法
本研究纳入了 1999-2018 年 NHANES 周期中的 21578 名参与者。HALP 评分的计算方法为血红蛋白（g/L）×白蛋白（g/L）×淋巴细胞（/L）/血小板（/L）。结局为通过 NHANES 链接的国家死亡索引记录确定的脑血管、心血管和全因死亡率，并随访至 2019 年 12 月 31 日。应用调查加权 Cox 回归、限制性立方样条分析和亚组分析来研究 HALP 评分与死亡率风险之间的关系。
结果
本队列研究中，49.2%为男性，50.8%为女性，中位年龄为 47 岁。在多变量调查加权 Cox 回归中，校正所有混杂因素后，与低 HALP 评分者相比，高 HALP 评分者的全因死亡率（校正 HR：0.80，95%CI：0.73，0.89，<0.0001）和心血管死亡率（校正 HR：0.61，95%CI：0.50，0.75，<0.0001）风险较低，中 HALP 评分者的全因死亡率（校正 HR：0.68，95%CI：0.62，0.75，<0.0001）和心血管死亡率（校正 HR：0.60，95%CI：0.48，0.75，<0.0001）风险最低。限制性立方样条分析显示 HALP 评分与心血管和全因死亡率之间呈非线性关系（所有 值<0.001）。
结论
HALP 评分与心血管和全因死亡率独立相关，但与脑血管死亡率无关。
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