Sex-specific association of the hemoglobin, albumin, lymphocyte, and platelet score with urinary incontinence: A cross-sectional study

Urinary incontinence (UI) significantly impairs patients' normal social activities and physical exercise, posing a major public health and socioeconomic challenge. The association between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and UI has not been extensively investigated, with few studies examining potential gender differences in this relationship. This research aimed to evaluate gender-specific associations between the hemoglobin, albumin, lymphocyte, and platelet score (HALP score) and UI. Utilizing data from the 2007 to 2018 National Health and Nutrition Examination Survey, we conducted weighted multivariable logistic regression analyses to assess relationships between the HALP score and UI subtypes, including stress, urge, and mixed incontinence (stress urinary incontinence [SUI], urge urinary incontinence [UUI], mixed urinary incontinence [MUI]). We applied smooth curve fitting techniques to investigate potential nonlinear relationships. Subgroup analyses were performed to evaluate the consistency of the UI-HALP connection among different stratifications. The Benjamini/Hochberg method was used to control the false detection rate. This study enrolled 28,113 participants, of whom 23.34% reported a history of SUI, 23.48% experienced UUI, and 10.51% had MUI. Regression models demonstrated a significant inverse relationship, indicating that elevated HALP scores were associated with reduced UI prevalence (SUI: odds ratio [OR] = 0.86, 95% confidence interval [CI] 0.75-0.97; UUI: OR = 0.85, 95% CI 0.77-0.93; MUI: OR = 0.85, 95% CI 0.76-0.96). Gender was found to modify the relationship between the HALP score and UI. Among male participants, higher HALP score demonstrated statistically significant negative correlations with the likelihood of all 3 UI subtypes (SUI: OR = 0.64, 95% CI 0.49-0.84; UUI: OR = 0.74, 95% CI 0.64-0.87; MUI: OR = 0.67, 95% CI 0.48-0.94). However, this association was not significant in females. This study revealed that higher HALP scores correlate with a decreased likelihood of UI in males, while no such association was observed in females.