Objective: To explore the differences in serum metabolic profiles of patients with hepatitis B virus (HBV) -related liver fibrosis and chronic hepatitis B (CHB)

and to search for potential biomarkers of HBV-related liver fibrosis. Methods: High-performance liquid chromatography-mass spectrometry was used to analyze the serum metabolic profiles of 16 HBV-related liver fibrosis and 16 CHB patients. By using statistical analysis and database search

the differential metabolites between the two groups were identified. Metabolic pathway analysis and enrichment analysis of differential metabolites using MetaboAnalyst 4.0 software screened out the primary metabolic pathways and differential metabolites on pathways. Finally

the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of major differential metabolites. Results: A total of 54 different metabolites were identified in the two groups. Metabolic pathways and enrichment analysis found that sphingolipid metabolism pathway[-log (P) =9.75

impact=0.42]and glycerophospholipid metabolism pathway[-log (P) =10.90

impact=0.06]were related to HBV-related liver fibrosis mainly enriched in metabolic pathways

including sphingomyelin

1-phosphate-sphingosine

sphingosine

ceramide and other four different metabolites enriched in sphingolipid metabolism pathways

while phosphatidylcholine

phosphatidyl serine

phosphatidylinositol

phosphatidic acid

phosphatidylglycerol and other five different metabolites were enriched in the glycerophospholipid metabo-lism pathway. ROC analysis showed that the areas under the ROC curve of the nine different metabolites were all greater than 0.700

and all had a good diagnostic performance. Conclusion: Sphingomyelin

1-phospho-sphingosine

sphingosine

ceramide

phosphatidylcholine

phosphatidylserine

phosphatidylinositol

phosphatidic acid

and phosphatidyl all have a high diagnostic accuracy of HBV-related liver fibrosis

which may be a potential metabolic biomarker for HBV-related liver fibrosis.