Association and dynamic change of fecal calprotectin with sepsis associated liver dysfunction in adults with sepsis

Fecal calprotectin (FC) is a biomarker of gut inflammation but its association with sepsis associated liver dysfunction (SALD) is unclear. This single-center, prospective cohort study investigated the relationship between FC and SALD in adults with sepsis. FC concentrations were measured on days 1 (FC1) and 3 (FC3). The difference between FC3 and FC1 (∆FC) was calculated. The relationship between FC and SALD was assessed using multivariate analysis. Receiver operating characteristic curves were used to assess the predictive value of SALD biomarkers. Ninety-five patients with sepsis (33 with SALD and 62 without SALD) were enrolled between January 2023 and March 2024. The median FC3 level and ∆FC were significantly higher in the SALD group than in the non-SALD group (both p < 0.001), whereas the median FC1 level did not differ significantly between groups. FC3 level and ∆FC were positively associated with SALD in the adjusted analysis (both p < 0.001) with areas under the curve of 0.784 and 0.848, respectively, and cut-off values of 930.88 μg/g and - 8.80 μg/g, respectively. In adults with sepsis, SALD occurrence was more strongly associated with elevated FC3 levels and ∆FC than with FC1 levels; therefore, monitoring FC3 levels and ∆FC could help detect SALD.