Association of Inflammatory Biomarkers with Child–Pugh and MELD Scores in Alcohol-Related Cirrhosis

Background: Cirrhosis is characterized by persistent systemic inflammation and immune dysregulation, both contributing to disease progression and poor clinical outcomes. Readily available inflammatory biomarkers have been proposed as complementary tools for disease severity assessment; however, data in alcohol-related cirrhosis remain limited. This study aimed to evaluate the association between inflammatory markers and established severity scores in patients with alcohol-related cirrhosis. Methods: This prospective cross-sectional observational single-center study included 114 consecutively enrolled patients with alcohol-related cirrhosis (mean age 58.48 ± 9.09 years; 77.19% male) at the Gastroenterology/Internal Medicine I Department of the Emergency Clinical Hospital of Craiova between September 2024 and February 2025. Inflammatory biomarkers, including C-reactive protein, ferritin, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII), were analyzed in relation to Child–Pugh and MELD scores. Correlation and regression analyses were performed to assess their associations with disease severity. Results: CRP, ferritin, NLR, and LMR showed significant correlations with both Child–Pugh and MELD scores, whereas PLR and SII were not significantly associated with disease severity. In multivariable analyses, ferritin remained significantly associated with both Child–Pugh and MELD severity, whereas LMR remained significantly associated only with Child–Pugh severity. Overall, correlations were numerically stronger for Child–Pugh with CRP and LMR, whereas ferritin and NLR showed a slightly stronger correlation with MELD. Conclusions: Several inflammatory biomarkers were associated with established severity scores in alcohol-related cirrhosis, with ferritin showing the most consistent association across both scoring systems. These findings support the relationship between systemic inflammation and disease severity in alcohol-related cirrhosis.