Serum ApoB/ApoA1 ratio in patients with chronic hepatitis B and the occurrence of HBV related cirrhosis and HBV related hepatocellular carcinoma

Abstract Background Clinical studies have found that chronic HBV infection affects the occurrence of cardiovascular disease by regulating cholesterol metabolism in liver cells. High serum apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio participates in the above regulation and is a risk factor for cardiovascular disease. However, it is unclear whether the ApoB/ApoA1 ratio is associated with chronic HBV infection and its disease progression. Method According to the inclusion and exclusion criteria, all 328 participants treated at Renmin Hospital of Wuhan University from March 2021 to March 2022, were divided into HCC group (107 cases), LC group (64 cases), CHB group (62 cases), Chronic hepatitis C (CHC) group (46 cases) and Hepatitis E Virus (HEV) group (49 cases). Serum ApoA1 and ApoB concentrations were measured at admission, and the ApoB/ApoA1 ratio was calculated. We compared the levels of laboratory parameters in each group and further analyzed ApoB/ApoA1 levels in HCC patients and LC patients with different severity. ROC curves were plotted to analyze the early diagnostic ability of ApoB/ApoA1 ratio for HBV-related HCC. Logistic regression and restricted cubic spline analysis were used to investigate the association between ApoB/ApoA1 ratio and LC and HCC risk. Result Comparison of ApoB/ApoA1 ratio between the groups: HEV group > CHB group > LC group > HCC group > CHC group, early-stage HCC > middle-stage HCC > advanced-stage HCC, Class A LC > Class B LC > Class C LC. Serum ApoB/ApoA1 ratio combined diagnosis with AFP could improve the detection efficacy and specificity of AFP for HCC.The incidence of LC and HCC in each logistic regression model was negatively correlated with the serum ApoB/ApoA1 ratio in CHB patients ( P < 0.05). After adjusting for all confounding factors included in this study, restricted cubic spline analysis found that within a certain range, serum ApoB/ApoA1 ratio was inversely associated with the prevalence of LC or HCC in CHB patients. Conclusion Serum ApoB/ApoA1 ratio in CHB patients may help identify high-risk patients for HCC or LC, thereby preventing the development of HCC or LC, or early diagnosis of HCC.