%0 Journal Article
%T HALP评分与合并糖尿病的心血管疾病人群死亡风险相关性分析&#65306;基于NHANES的回顾性队列研究<br>Correlation Analysis between HALP Score and Mortality Risk in Cardiovascular Disease Patients with Diabetes: A Retrospective Cohort Study Based on NHANES Data
%A 林凡辉
%A 王军华
%A 戴红艳
%J Advances in Clinical Medicine
%P 711-726
%@ 2161-8720
%D 2024
%I Hans Publishing
%R 10.12677/acm.2024.14123139
%X 目的&#65306;评估血红蛋白、白蛋白、淋巴细胞和血小板评分(HALP评分)与患有糖尿病的心血管疾病人群的全因和心因死亡风险的相关性。方法&#65306;基于1999~2018年美国国家健康与营养检查调查(NHANES)数据库&#65292;采用自然对数转化后的HALP评分(LnHALP)进行研究。使用加权多变量调整Cox分析、Kaplan-Meier生存曲线分析其与全因和心因特异性死亡率的关系&#65292;并通过限制性立方样条(RCS)分析评估非线性关系。结果&#65306;最终共纳入2621名参与者&#65292;在调整了混杂因素后&#65292;加权多因素Cox回归提示&#65292;LnHALP每升高1单位&#65292;参与者全因死亡率显著降低26% [HR = 0.74, 95%CI: 0.64~0.85]&#65292;心因死亡率降低33% [HR = 0.67, 95%CI: 0.52~0.87]。与最低三分位数人群相比&#65292;LnHALP最高三分位数人群的全因和心因死亡风险分别下降了23% [HR = 0.77, 95%CI: 0.65~0.91]、31% [HR = 0.69, 95%CI: 0.53~0.91]。限制性立方样条分析显示LnHALP评分与死亡风险呈现非线性关系&#65292;LnHALP评分与全因和心因死亡风险呈J形曲线。结论&#65306;HALP评分与患有糖尿病的心血管疾病人群的全因死亡率和心因死亡率之间独立相关。<br>Objective: To evaluate the association between hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the risk of all-cause and cardiovascular mortality among patients with diabetes and cardiovascular disease. Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2018. Due to the skewed distribution of HALP scores, we employed the natural logarithm-transformed HALP score (LnHALP) for subsequent analyses. The associations between LnHALP scores and all-cause and cardiovascular-specific mortality were examined using weighted multivariate-adjusted Cox regression analysis and Kaplan-Meier survival curves. Restricted cubic spline (RCS) analysis was performed to evaluate potential non-linear relationships. Results: A total of 2621 participants were included in the final analysis. After adjusting for confounding factors including age, gender, race, poverty-income ratio, education level, hypertension, body weight, estimated glomerular filtration rate (eGFR), chronic kidney disease, hyperlipidemia, smoking, and alcohol consumption, the weighted multivariate Cox regression analysis revealed that each unit increase in LnHALP was associated with a 26% reduction in all-cause mortality risk [HR = 0.74, 95%CI: 0.64~0.85] and a 33% reduction in cardiovascular mortality risk [HR = 0.67, 95%CI: 0.52~0.87]. When participants were stratified into tertiles based on LnHALP scores, those in the highest tertile demonstrated a 23% lower risk of all-cause mortality [HR = 0.77, 95%CI: 0.65~0.91] and a 31% lower risk of cardiovascular mortality [HR = 0.69, 95%CI: 0.53~0.91] compared to those in the lowest tertile. Restricted cubic spline analysis demonstrated a nonlinear relationship between LnHALP score and mortality risk, with J-shaped curves observed between LnHALP score and both all-cause and cardiovascular mortality. Conclusion: The HALP score demonstrates an
%K NHANES&#65292
%K HALP评分&#65292
%K 心血管疾病&#65292
%K 死亡结局<br>NHANES
%K HALP Score
%K Cardiovascular Disease
%K Mortality
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=102901