| Title: | Association of the HALP score with baseline and incident physical-cognitive comorbidity and mortality: evidence from the WCHAT and UK Biobank cohorts |
| Journal: | Frontiers in Public Health |
| Published: | 22 May 2026 |
| DOI: | https://doi.org/10.3389/fpubh.2026.1842125 |
| URL: | https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1842125/pdf |
Publication 19946
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Abstract
Objective
To evaluate the associations of the hemoglobin-albumin-lymphocyte-platelet (HALP) score with baseline physical-cognitive comorbidity, incident physical-cognitive comorbidity, and all-cause mortality using two independent cohorts.</p>Methods
Data were derived from the West China Health and Aging Trend (WCHAT) cohort and the UK Biobank (UKB). Participants aged ≥50 years with available laboratory, covariate, and functional data were included. Physical-cognitive comorbidity was defined as the coexistence of low grip strength and cognitive impairment. Multivariable logistic regression was used for cross-sectional analyses in both cohorts. Cox proportional hazards models were used to examine incident physical-cognitive comorbidity in WCHAT and all-cause mortality among participants with baseline comorbidity in UKB. Continuous-variable, subgroup, sensitivity, and restricted cubic spline analyses were additionally performed, and an exploratory incidence analysis was conducted in UKB participants without baseline comorbidity.</p>Results
A total of 5,957 participants in WCHAT and 101,655 participants in UKB were included in the baseline analyses. In both cohorts, higher HALP scores were associated with a lower risk of baseline physical-cognitive comorbidity. In the fully adjusted models, the odds ratio comparing Quartile 4 (Q4) with Quartile 1 (Q1) was 0.79 (95% CI: 0.62-0.99) in WCHAT and 0.77 (95% CI: 0.66-0.89) in UKB. In WCHAT, among 2,782 participants free of comorbidity at baseline, 330 incident events occurred, and higher HALP was associated with lower incident risk (Q4 vs. Q1: HR = 0.70, 95% CI: 0.52-0.94; per 1-SD increase: HR = 0.88, 95% CI: 0.79-0.99). In UKB, among 1,393 participants with baseline comorbidity, 227 deaths occurred, and higher HALP was associated with lower all-cause mortality (Q4 vs. Q1: HR = 0.65, 95% CI: 0.45-0.93; per 1-SD increase: HR = 0.80, 95% CI: 0.70-0.92). Findings were generally consistent in subgroup and sensitivity analyses, whereas time-dependent ROC-AUC analysis showed limited discrimination of the HALP-only model.</p>Conclusion
Higher HALP scores were associated with lower risks of baseline and incident physical-cognitive comorbidity and with better survival among participants with baseline physical-cognitive comorbidity. HALP may provide complementary information for immune-nutritional risk assessment, but it should not be interpreted as an independent predictive tool.</p></p>
7 Authors
- Chaoxin Gao
- Yiheng Zhou
- Rongna Lian
- Birong Dong
- Jirong Yue
- Haiyang Chen
- Xiaolei Liu
1 Application
| Application ID | Title |
|---|---|
| 1054018 | Epidemiology and Health Outcomes of Sarcopenia and Sarcopenic Obesity: Evidence from the UK Biobank |
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