ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1570474
Inflammatory Markers CRP and WBC as Predictors of Liver Function Impairment in Multiple Injury Trauma Patients: A Repeated Measures Analysis
Provisionally accepted
- 1Huzhou College, Huzhou, China
- 2Zhejiang Xinda Hospital, huzhou, China
- 3South Taihu Hospital affiliated to Huzhou College, huzhou, China
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To investigate the relationship between liver function indices (AST, ALT, GGT) and inflammatory markers (CRP, white blood cell count) in multiple injury patients at different time points post-trauma.We retrospectively analyzed 114 patients with multiple injuries admitted to a tertiary trauma center in Zhejiang Province (January 2023-December 2024). AST, ALT, GGT, CRP, white blood cell count, NLR, and LMR were measured at admission, 24h, and 72h post-admission. Age, drinking history, BMI, and gender were included as covariates. Statistical analyses employed both crude and adjusted GEE models with gender subgroup analysis.Results: Elevated CRP levels significantly correlated with increased AST (OR=2.17, 95% CI: 1.14-4.12, P=0.019) and ALT (OR=2.37, 95% CI: 1.22-4.63, P=0.011). The 72h time point independently predicted ALT elevation (OR=2.24, 95% CI: 1.37-3.65, P<0.001). NLR (OR=0.94, 95% CI: 0.90-0.99, P=0.014) and WBC count (OR=1.89, 95% CI: 1.12-3.18, P=0.017) significantly predicted GGT elevation. Gender-stratified analysis revealed distinct patterns: In females, CRP elevation (both ≥40 mg/L and 10 -40 mg/L) was inversely associated with AST (P<0.05), and higher WBC correlated with lower GGT (B=-0.636, P=0.017). In males, higher WBC was associated with lower AST; ALT decreased at 24h (B=-1.08, P<0.001) and 72h (B=-1.11, P<0.001); CRP 10 -40 mg/L inversely correlated with ALT (B=-0.882, P=0.008); and both higher WBC (B=-0.812, P=0.013) and NLR (B=-0.063, P=0.013) predicted lower GGT.Conclusions: CRP and white blood cell count significantly correlate with liver function changes in multiple injury patients, with marked gender-specific differences in these associations. These findings suggest the need for sex-specific monitoring strategies in trauma-related hepatic dysfunction.
Keywords: Multiple Trauma, Liver function index, inflammatory index, generalized estimating equation, Gender difference
Received: 17 Feb 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Wang, Tang, Wang, Xu, Shen and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gaokai Li, Huzhou College, Huzhou, China
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