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The Hemoglobin-Albumin-Lymphocyte-Platelet Score and Diabetic Neuropathy in Patients with Type 2 Diabetes Mellitus
Aysun Şeker1, Seydahmet Akin1, Doğa Coşkun2
1Kartal Dr Lutfi Kirdar City Hospital, Department of Internal Medicine, Istanbul, Turkey, Istanbul.
Background:
Diabetic neuropathy is a common microvascular complication of type 2 diabetes mellitus associated with chronic inflammation and metabolic dysregulation. The hemoglobin-albumin-lymphocyte-platelet score is a composite index reflecting nutritional and inflammatory status, but its association with diabetic neuropathy remains insufficiently characterized.
Methods:
In this retrospective cross-sectional study, 212 patients with type 2 diabetes mellitus were evaluated. Diabetic neuropathy was defined using electrophysiological criteria. Multivariable logistic regression analysis was performed to assess the association between the hemoglobin-albumin-lymphocyte-platelet score and diabetic neuropathy after adjustment for age, sex, diabetes duration, body mass index, and glycated hemoglobin. The hemoglobin-albumin-lymphocyte-platelet score was analyzed as a continuous variable (per 0.1-unit increase) and in quartiles. Receiver operating characteristic curve analysis was used to evaluate model discrimination.
Results:
Diabetic neuropathy was present in 45.2% of patients. The hemoglobin-albumin-lymphocyte-platelet levels were significantly lower in patients with diabetic neuropathy compared to those without diabetic neuropathy (0.36±0.18 vs. 0.72±0.39, p<0.001). In multivariable analysis, the hemoglobin-albumin-lymphocyte-platelet score remained independently associated with diabetic neuropathy (odds ratio per 0.1-unit increase: 0.46, 95% confidence interval: 0.35-0.58, p<0.001). Quartile analysis showed a graded inverse association (p for trend<0.001). The addition of the hemoglobin-albumin-lymphocyte-platelet score improved model discrimination compared to the base model (area under the curve: 0.868 vs. 0.567).
Conclusions:
The hemoglobin-albumin-lymphocyte-platelet score is inversely associated with diabetic neuropathy in patients with type 2 diabetes mellitus and may represent an integrated marker of metabolic and inflammatory burden.
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