Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers

İsmail Bağlar; Fatih Şanlıkan; Esra Keles; Buket Yiğit Çivi; Şevki Göksun Gökulu; Hilal Aşci; Dilanur Ağır; Burak Sezgin

doi:10.19161/etd.1827265

TR EN

HALP preeklampsi için yeni bir belirteç mi? HALP indeksinin tanısal doğruluğunun diğer inflamatuar ve nutrisyonel belirteçlere karşı retrospektif değerlendirmesi

Abstract

Amaç: Preeklampsi (PE), anne ve bebek sağlığı açısından önemli bir tehdit oluşturmaktadır. Hemoglobin-Albümin-Lenfosit-Trombosit (HALP) indeksi ise inflamasyon ve beslenme durumu hakkında bilgi veren yeni bir biyobelirteç olarak öne çıkmaktadır. Bu çalışmanın amacı, HALP indeksinin PE tanısındaki başarımını, yaygın olarak kullanılan diğer inflamatuar ve nutrisyonel göstergelerle karşılaştırmalı olarak değerlendirmektir. Gereç ve Yöntem: Retrospektif tasarıma sahip bu vaka-kontrol çalışmasında, 2020–2025 yılları arasında bir üçüncü basamak hastanede doğum yapan, PE tanısı almış 173 kadın ve sağlıklı, tansiyonu normal olan 185 gebe kontrol grubu olarak incelendi. Katılımcılara ait HALP skoru, Prognostik Nutrisyonel İndeks (PNI), Nötrofil-Lenfosit Oranı (NLR), Sistemik İmmün-İnflamasyon İndeksi (SII) ve serum ürik asit/kreatinin oranı (sUA/sCr) hesaplandı. Tanısal performans, ROC eğrileri aracılığıyla ve AUC (Eğri Altındaki Alan) değerleri karşılaştırılarak değerlendirildi. Bulgular: PE grubundaki kadınlarda HALP skoru (2.5 vs 3.8) ve PNI değeri (34.5 vs 41.0) anlamlı şekilde düşük bulundu (her ikisi için p < 0.001). Buna karşılık, NLR, SII, serum ürik asit düzeyi ve sUA/sCr oranı PE grubunda anlamlı olarak daha yüksekti ( p < 0.001). ROC analizine göre en yüksek tanısal doğruluk, 0.805 AUC değeriyle ürik asitteydi (GA %95: 0.758-0.852). HALP skoru ise anlamlı fakat görece düşük bir tanısal doğruluk sergiledi (AUC: 0.625, GA %95: 0.566-0.684) ve bu değer diğer belirteçlere kıyasla anlamlı düzeyde düşüktü (tüm karşılaştırmalar için p < 0.01). Sonuç: HALP skoru, preeklampsili kadınlarda belirgin şekilde düşük olmasına rağmen, hastalığın tanısı sırasında gösterdiği tanısal performans; ürik asit, sUA/sCr, PNI ve SII gibi yerleşik biyobelirteçlerin gerisinde kalmaktadır.

Keywords

Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers

Abstract

Aim: Preeclampsia (PE) poses a significant threat to maternal and fetal health. The Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) index has emerged as a novel biomarker providing information on inflammation and nutritional status. The aim of this study is to evaluate the performance of the HALP index in diagnosing PE, comparing it with other commonly used inflammatory and nutritional markers. Materials and Methods: In this retrospective case-control study, 173 women who gave birth at a tertiary hospital between 2020 and 2025 and were diagnosed with PE were examined, along with a control group of 185 healthy pregnant women. The HALP score, Prognostic Nutritional Index (PNI), Neutrophil-Lymphocyte Ratio (NLR), Systemic Immune-Inflammation Index (SII), and serum uric acid/creatinine ratio (sUA/sCr) were calculated for the participants. Diagnostic performance was evaluated using ROC curves and comparing AUC (Area Under the Curve) values. Results: In women in the PE group, the HALP score (2.5 vs. 3.8) and PNI value (34.5 vs. 41.0) were significantly lower (p < 0.001 for both). In contrast, NLR, SII, serum uric acid level, and sUA/sCr ratio were significantly higher in the PE group (all p < 0.001). According to ROC analysis, uric acid had the highest diagnostic accuracy with an AUC value of 0.805 (95% CI: 0.758-0.852). The HALP score showed a significant but relatively low diagnostic accuracy (AUC: 0.625, 95% CI: 0.566-0.684),(p < 0.01 for all). Conclusions: Although the HALP score is significantly lower in women with preeclampsia, its diagnostic performance during diagnosis lags behind established biomarkers such as uric acid, sUA/sCr, PNI, and SII.

Keywords

Supporting Institution

non

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of University of Health Sciences Turkey, Kartal City Hospital Ethics Committee on 30.10.2025 with [Decision No: 2025/010.99/21/30

Thanks

non

References

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Details

Primary Language

English

Subjects

Surgery (Other)

Journal Section

Research Article

Authors

İsmail Bağlar ^*
0009-0008-0619-7111
Türkiye

Fatih Şanlıkan
0000-0002-3166-7129
Türkiye

Esra Keles
0000-0001-8099-8883
Türkiye

Buket Yiğit Çivi
0009-0002-6201-4582
Türkiye

Şevki Göksun Gökulu
0000-0002-6581-5716
Türkiye

Hilal Aşci
0009-0005-0237-0560
Türkiye

Dilanur Ağır
0009-0001-8191-3228
Türkiye

Burak Sezgin
0000-0003-2938-5816
Türkiye

Publication Date

June 10, 2026

Submission Date

November 20, 2025

Acceptance Date

February 5, 2026

Published in Issue

Year 2026 Volume: 65 Number: 2

DOI

https://doi.org/10.19161/etd.1827265

IZ

https://izlik.org/JA58JJ67PH

Cite

RIS / Bibtex

APA

Bağlar, İ., Şanlıkan, F., Keles, E., Yiğit Çivi, B., Gökulu, Ş. G., Aşci, H., Ağır, D., & Sezgin, B. (2026). Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers. Ege Tıp Dergisi, 65(2), 268-274. https://doi.org/10.19161/etd.1827265

AMA

1.Bağlar İ, Şanlıkan F, Keles E, et al. Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers. EJM. 2026;65(2):268-274. doi:10.19161/etd.1827265

Chicago

Bağlar, İsmail, Fatih Şanlıkan, Esra Keles, et al. 2026. “Is HALP a New Marker for Preeclampsia? Retrospective Evaluation of the Diagnostic Accuracy of the HALP Index Compared to Other Inflammatory and Nutritional Markers”. Ege Tıp Dergisi 65 (2): 268-74. https://doi.org/10.19161/etd.1827265.

EndNote

Bağlar İ, Şanlıkan F, Keles E, Yiğit Çivi B, Gökulu ŞG, Aşci H, Ağır D, Sezgin B (June 1, 2026) Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers. Ege Tıp Dergisi 65 2 268–274.

IEEE

[1]İ. Bağlar et al., “Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers”, EJM, vol. 65, no. 2, pp. 268–274, June 2026, doi: 10.19161/etd.1827265.

ISNAD

Bağlar, İsmail - Şanlıkan, Fatih - Keles, Esra - Yiğit Çivi, Buket - Gökulu, Şevki Göksun - Aşci, Hilal - Ağır, Dilanur - Sezgin, Burak. “Is HALP a New Marker for Preeclampsia? Retrospective Evaluation of the Diagnostic Accuracy of the HALP Index Compared to Other Inflammatory and Nutritional Markers”. Ege Tıp Dergisi 65/2 (June 1, 2026): 268-274. https://doi.org/10.19161/etd.1827265.

JAMA

1.Bağlar İ, Şanlıkan F, Keles E, Yiğit Çivi B, Gökulu ŞG, Aşci H, Ağır D, Sezgin B. Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers. EJM. 2026;65:268–274.

MLA

Bağlar, İsmail, et al. “Is HALP a New Marker for Preeclampsia? Retrospective Evaluation of the Diagnostic Accuracy of the HALP Index Compared to Other Inflammatory and Nutritional Markers”. Ege Tıp Dergisi, vol. 65, no. 2, June 2026, pp. 268-74, doi:10.19161/etd.1827265.

Vancouver

1.İsmail Bağlar, Fatih Şanlıkan, Esra Keles, Buket Yiğit Çivi, Şevki Göksun Gökulu, Hilal Aşci, Dilanur Ağır, Burak Sezgin. Is HALP a new marker for preeclampsia? Retrospective evaluation of the diagnostic accuracy of the HALP index compared to other inflammatory and nutritional markers. EJM. 2026 Jun. 1;65(2):268-74. doi:10.19161/etd.1827265