乙型肝炎病毒-代谢相关脂肪性肝病共病患者脂质代谢紊乱与□腔微生物组及代谢产物变化相关

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Abstract：ObjectiveTo investigate the impact of hepatitis B virus （HBV）infection onoral microbiotaand metabolites in patients with metabolic dysfunction-associated faty liver disease （MAFLD）and the underlying mechanisms. Methods This prospective study was conducted in 47 MAFLD patients complicated with chronic hepatitis B （CHB）and 48 MAFLDpatients withoutCHeolldfroNovebe，23toJauary24.astingtonguecoaingsampleserecollctedfrotetiet foranalyzingmicrobialcommunitystructuresandmetabolitesusinghigh-throughput16SrDNAsequencingandnon-targeted metabolomics techniques，and theirassociations withclinical indicatorsandbiological pathways wereexploredusing correlationanalysisandfunctionalannotation.ResultsThelevelsoffastingbloodglucosetotalcholesterol（TC），gammglutamyltransferase（GGT），andseverityoffattyliver wereallsignificantlylowerinMAFLD+CHBgroupthaninMAFLD group.Microbiotaanalysis showed that the abundancesof Patescibacteria （at thephylumlevel），Hydrogenophaga，and Absconditabacteriales（atthegenuslevel）wereignficantlyincreased，whiletheabundanceofMegasphaerawaseasedin MAFLD+CHBgroup.ThediferentialmicrobiotaweresignificantlycorrelatedwithTC，GGTandlow-densitylipoprotein （r=-0.68-0.75）.Metabolomicsanalysisrevealedthat469metabolites （includinglipidsandaminoacids）wereupregulatedand 2306 （including organic oxygen-containing compounds and phenylpropanoids） were downregulated in MAFLD 1+ CHB group， forwhichKEGGenrichmentanalysissuggestedabnormalactivationof thelinoleicacidmetabolismandglycerophospholipid metabolismpathways.CorrelationanalysisbetweenmicrobiotaandmetabolitesindicatedthatPatescibacteriaandMegasphaera whichwereosiielyeaedithdmeablisdgaielyitattcidetabolitspilytlyte glycolipid metabolismandoxidativestresspathways.ConclusionCompared topatients withMAFLDalone，MAFLDpatients withconcurentchronicHBVinfectionshowedlowerlevelsinsomelipidmetabolismindicatorsandthedegreeof hepatic steatosis，acompaniedbyalterationsinoral microbiotastructureandmetabolicprofiles.Theprecisemechanismsnvolved require further investigation to be fully elucidated.

Keywords：hepatitisBvirus；metabolicdysfunction-associatedfatyliverdisease；oralmicrobiota;metabolomics;lipid metabolismdisorders;oral-liveraxis

随着现代生活方式与饮食习惯的变迁，肥胖、2型糖尿病（T2DM）及代谢综合征的发病率持续攀升，代谢相关性脂肪性肝病（MAFLD）也跃升为全球最为普遍的慢性肝病之一]。（剩余17843字）