Gut Microbiota Dysbiosis, Endotoxigenic Index, Atherogenic Index of Plasma, Dyslipidemia, and Liver Enzymes in Chronic Hepatitis B Virus: A Case-Control Study

Abstract

Context:
Gut microbiota dysbiosis has been associated with chronic inflammation, dyslipidemia, and the progression of liver damage in chronic hepatitis B virus (CHBV) infection.

Aim:
To evaluate serum endotoxin (LPS), lipid profile, liver enzymes, and platelet count (PLT) in subjects with CHBV and assess the potential role of gut dysbiosis in dyslipidemia and liver disease progression.

Settings and Design:
This case-control study was conducted at a tertiary healthcare facility to assess the impact of gut microbiota dysbiosis on dyslipidemia and liver function in CHBV patients.

Materials and Methods:
The study enrolled 40 subjects with CHBV and liver fibrosis (LF), and 40 healthy controls. Serum LPS levels were measured using ELISA. Liver enzymes, lipids, and PLT were determined using spectrophotometry and an automated hematology analyzer, respectively. LDL and VLDL cholesterol, endotoxigenic index (EI), and atherogenic index of plasma (AIP) were computed. Data were analyzed using ANOVA, Tukey-HSD post hoc tests, receiver operating characteristic (ROC) curves, and Pearson’s correlation at p < 0.05.

Results:
Compared with controls, subjects with CHBV and LF had significantly elevated liver enzymes, lipids, LPS, EI, and AIP, and reduced PLT (p < 0.05). Liver enzymes and LPS were significantly higher in dyslipidemic CHBV patients than in CHBV patients with normal lipid levels (p < 0.05). EI correlated positively with AIP (r = 0.559, p = 0.000). ROC analysis showed that EI and ALT had area under the curve (AUC) values of 1.000 and 0.916, maximum Kolmogorov-Smirnov metrics of 1.000 and 0.717, and sensitivities/specificities of 100%/100% and 92%/80%, respectively.

Conclusion:
Gut microbiota dysbiosis, dyslipidemia, endotoxigenic index, and AIP may serve as useful adjunctive markers for evaluating CHBV severity and progression. Further longitudinal and mechanistic studies are warranted to validate these findings.