AUTHOR=Wang Gang , Tang Cui , Wang Rui , Xu Chundao , Shen Tugang , Li Gaokai 

TITLE=Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1570474

DOI=10.3389/fmed.2025.1570474

ISSN=2296-858X

ABSTRACT=AimsTo 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.MethodsWe 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, 24 h, and 72 h 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.ResultsElevated 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 72 h 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 24 h (B = –1.08, p < 0.001) and 72 h (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.ConclusionCRP 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.