Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) Score and Diabetic Neuropathy in Patients with Type 2 Diabetes Mellitus

Background Diabetic neuropathy (DN) is a common microvascular complication of type 2 diabetes mellitus (T2DM), associated with chronic inflammation and metabolic dysregulation. The hemoglobin-albumin-lymphocyte-platelet (HALP) score is a composite index reflecting nutritional and inflammatory status, but its association with DN remains insufficiently characterized. Methods In this retrospective cross-sectional study, 212 patients with T2DM were evaluated. DN was defined using electrophysiological criteria. Multivariable logistic regression analysis was performed to assess the association between HALP and DN after adjustment for age, sex, diabetes duration, body mass index, and HbA1c. HALP was analyzed as a continuous variable (per 0.1-unit increase) and in quartiles. Receiver operating characteristic (ROC) curve analysis was used to evaluate model discrimination. Results Diabetic neuropathy was present in 45.2% of patients. HALP levels were significantly lower in patients with DN compared to those without DN (0.36 ± 0.18 vs. 0.72 ± 0.39, p < 0.001). In multivariable analysis, HALP remained independently associated with DN (OR per 0.1-unit increase: 0.46, 95% CI 0.35-0.58, p < 0.001). Quartile analysis showed a graded inverse association (p for trend < 0.001). The addition of HALP improved model discrimination compared to the base model (AUC 0.868 vs. 0.567). Conclusion HALP is inversely associated with diabetic neuropathy in patients with T2DM and may represent an integrated marker of metabolic and inflammatory burden.