Abstract: Objective To evaluate liver elasticity and blood lipid distributionin in patients with primary biliary cholangitis (PBC) and to assess changes in blood lipid levels across different stages of liver fibrosis in PBC. Methods A retrospective analysis was conducted on the clinical data of 70 patients with PBC and 71 age- and sex-matched patients with non-alcoholic fatty liver disease (NAFLD) who visited the Central Theater General Hospital between 2019 and 2023. Dyslipidemia distribution and liver elasticity characteristics were compared between the two groups. Additionally, blood lipid distribution was evaluated across different stages of liver stiffness in the PBC group. Results In the PBC group, dyslipidemia was primarily driven by elevated total cholesterol (TC), whereas in the NAFLD group, increased triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) were predominant. Clinical analysis revealed that TC (6.01 [5.42, 6.59] mmol/L )and high-density lipoprotein cholesterol (HDL-C)( 1.54 [1.26, 1.77] mmol/L ) levels in the PBC group were significantly higher than in the NAFLD group. Conversely, TG( 2.00 [1.00, 2.00] mmol/L) and LDL-C (2.99 [2.60, 3.32] mmol/L) levels were higher in the NAFLD group, with statistically significant differences. Despite similar transaminase levels, liver elasticity tests indicated that Controlled Attenuation Parameter(CAP) values in the PBC group(207 [179.5, 241.0] dB/m) were lower than in the NAFLD group, whereas liver stiffness measurement(LSM) values were higher(6.6 [5.15, 11.1] kPa), both showing statistically significant differences. Additionally, variations in blood lipid distribution within the PBC group were observed at different LSM stages. At LSM values between 7.3-9.8 kPa, TC( 6.54[(6.03, 8.03] mmol/L) and LDL-C (3.08±0.79 mmol/L) reached peak levels, followed by a decrease before 17.3 kPa. When LSM exceeded 17.3 kPa, TC (4.26 [3.95, 5.13] mmol/L and LDL-C (1.81±0.47 mmol/L) were at their lowest levels. All observed differences were statistically significant. Conclusion The lipid and liver elasticity profiles in PBC and NAFLD exhibit distinct characteristics. In PBC. dyslipidemia primarily results from TC, with TC and LDL-C levels showing the most significant increases in the early stages of fibrosis and changeing progressively with fibrosis advancement.

Key words: Primary biliary cholangitis, Dyslipidemia, Transient elastography, Liver fibrosis