Association Between Hashimoto's Thyroiditis and Hemoglobin-Albumin Score and Systemic Inflammatory Index: A Nationwide Cohort Study

Abstract

ObjectivesHashimoto's thyroiditis (HT) is a T-cell mediated autoimmune disease characterized by the progressive destruction of thyroid gland. Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score and systemic inflammatory index (SII) are novel markers of inflammation. We aimed to compare HALP score and SII values of patients with HT to those in healthy control subjects in the present study.MethodsPatients 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 countxNeutrophil count)/Lymphocyte count. HALP score = (HemoglobinxSerum AlbuminxLymphocyte count)/Platelet count. SII and HALP score of patients with HT and healthy controls were compared.ResultsMedian SII of the patients with HT (510 (140-3646)) was significantly higher than that of the control subjects (422 (102-2173)) (p < 0.001). Median HALP score of the HT group (47 (7-149)) was significantly lower than that of the control group (54 (10-160)) (p < 0.001). The sensitivity and specificity of 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 in detecting 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 in HALP score decreased the risk of HT by 2% (p < 0.001, OR: 0.977, 95%CI: 0.968-0.985).ConclusionWe recommend that, due to their inexpensive and easily assessable nature, SII and HALP score could serve as additional diagnostic tools in HT.