Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis
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 tra...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1570474/full |
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| author | Gang Wang Cui Tang Rui Wang Chundao Xu Tugang Shen Gaokai Li |
| author_facet | Gang Wang Cui Tang Rui Wang Chundao Xu Tugang Shen Gaokai Li |
| author_sort | Gang Wang |
| collection | DOAJ |
| description | 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. |
| format | Article |
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| publishDate | 2025-08-01 |
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| spelling | doaj-art-a1f984c93c834cffa2191a1a7ce2d2532025-08-01T05:31:58ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.15704741570474Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysisGang Wang0Cui Tang1Rui Wang2Chundao Xu3Tugang Shen4Gaokai Li5School of Life and Health, Huzhou College, Huzhou, Zhejiang, ChinaZhejiang Xinda Hospital, Huzhou, Zhejiang, ChinaSchool of Life and Health, Huzhou College, Huzhou, Zhejiang, ChinaDepartment of Orthopaedics, South Taihu Hospital Affiliated to Huzhou College, Huzhou, Zhejiang, ChinaDepartment of Orthopaedics, South Taihu Hospital Affiliated to Huzhou College, Huzhou, Zhejiang, ChinaSchool of Life and Health, Huzhou College, Huzhou, Zhejiang, ChinaAimsTo 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.https://www.frontiersin.org/articles/10.3389/fmed.2025.1570474/fullmultiple traumaliver function indexinflammatory indexgeneralized estimating equationgender difference |
| spellingShingle | Gang Wang Cui Tang Rui Wang Chundao Xu Tugang Shen Gaokai Li Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis Frontiers in Medicine multiple trauma liver function index inflammatory index generalized estimating equation gender difference |
| title | Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis |
| title_full | Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis |
| title_fullStr | Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis |
| title_full_unstemmed | Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis |
| title_short | Inflammatory markers CRP and WBC as predictors of liver function impairment in multiple injury trauma patients: a repeated measures analysis |
| title_sort | inflammatory markers crp and wbc as predictors of liver function impairment in multiple injury trauma patients a repeated measures analysis |
| topic | multiple trauma liver function index inflammatory index generalized estimating equation gender difference |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1570474/full |
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