Association between Hashimoto's thyroiditis and hemoglobin-albumin-lymphocyte-platelet score and systemic inflammatory index: a nationwide cohort study

Abstract

Objectives: Hashimoto’s thyroiditis (HT) is a T-cell mediated autoimmune disease characterized by theprogressive destruction of thyroid gland. Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score andsystemic inflammatory index (SII) are novel markers of inflammation. We aimed to compare HALP scoreand SII values of patients with HT to those in healthy control subjects in the present study.Methods: Patients diagnosed with HT and healthy volunteers (as controls) were included in the study.The SII and HALP score were calculated using the following formulas: SII = (Platelet count×Neutrophilcount)/Lymphocyte count. HALP score = (Hemoglobin×Serum Albumin×Lymphocyte count)/Plateletcount. SII and HALP score of patients with HT and healthy controls were compared.Results: Median SII of the patients with HT (510 (140–3646)) was significantly higher than that of thecontrol subjects (422 (102–2173)) (p < 0.001). Median HALP score of the HT group (47 (7–149)) wassignificantly lower than that of the control group (54 (10–160)) (p < 0.001). The sensitivity and specificityof SII (when higher than 452%) in detecting HT were 61% and 62%, respectively (AUC: 0.64, p < 0.001,95%CI: 0.61–0.67). A HALP score lower than 49.5% threshold had 64% sensitivity and 57% specificity indetecting HT (AUC: 0.61, p < 0.001, 95%CI: 0.57–0.64). In logistic regression analysis (considering age,gender, eGFR, TSH, CRP, ESR, BMI), a unit increase in SII increased the risk of HT by 0.3% (p < 0.001, OR:1.003, 95%CI: 1.002–1.004). HALP score was also an independent risk factor for HT. A unit increase inHALP score decreased the risk of HT by 2% (p < 0.001, OR: 0.977, 95%CI: 0.968–0.985).Conclusion: We recommend that, due to their inexpensive and easily assessable nature, SII and HALPscore could serve as additional diagnostic tools in HT.