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Hemoglobin-albumin-lymphocyte-platelet score associated with diabetic foot severity, unlike modified systemic
Weiyu Pan1, Zhaoyuan Nie2, Qizhi Tang1
1Department of Endocrinology, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Guangzhou University of Chinese Medicine, Guangdong, China.
Background:
Accurate evaluation of diabetic foot severity and prompt intervention is expected to improve patient prognosis. Systemic inflammatory response and nutritional metabolic status play important roles in the progression of diabetic foot. The purpose of this study was to investigate the relationship between the hemoglobin-albumin-lymphocyte-platelet (HALP) score, modified systemic immune-inflammatory index (mSII), modified systemic inflammatory response index (mSIRI) and diabetic foot severity.
Methods:
A total of 367 diabetic foot patients were retrospectively enrolled, and divided into mild diabetic foot group (Wagner grade 0-2)(n=239) and severe diabetic foot group (Wagner grade 3-5)(n=128). Clinical baseline data and laboratory examination data of the patients were collected, and the HALP score, mSII and mSIRI were calculated. The differences in HALP score, mSII and mSIRI between patients with mild and severe diabetic foot were compared. Logistic regression analysis was performed to explore the associations of HALP score, mSII and mSIRI with severe diabetic foot.
Results:
The severe diabetic foot group had significantly higher levels of mSII (p < 0.001) and mSIRI (p < 0.001), while the HALP level was notably lower (p < 0.001) than mild diabetic foot group. The cutoff value of mSII was 5482.235, while mSIRI had a cutoff of 1465.115 and HALP had a cutoff of 16.8 by ROC analysis. Logistic regression analysis demonstrated that reduced HALP [≤16.8 vs. >16.8; odds ratio (OR)=2.113, 95% confidence interval (CI)=1.093-4.086, p = 0.026] were associated with severe diabetic foot after adjusting for other confounding factors (age, gender, history of alcohol abuse, history of smoking, history of cerebral infarction, history of coronary artery disease, and history of hypertension), but mSII (p = 0.227) and mSIRI (p = 0.771) not.
Conclusions:
The HALP score correlates with diabetic foot severity and can be used as a potential reference indicator for evaluating the severity of diabetic foot; mSII and mSIRI are not associated with the severity of diabetic foot.
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