Abstract: Objective The aim of this study was to investigate serum lipid profiling of patients with chronic hepatitis B （CHB）. Methods A ultra performance liquid chromatography tandem mass spectrometry （UPLC-MS/MS） platform was applied for serum lipid profiling in 17 patients with CHB and 23 healthy volunteers. Orthogonal partial least squares discriminant analysis（OPLS-DA） model and univariate analysis were established to analyze the characteristic metabolites and the association with histological severities. Results There were significant lipids changes in the CHB patients ［OPLS-DA:R2=0.775，Q2=0.518，P（CV-ANOVA）=2.81×10^-4］， and 64 lipids with significant differences（VIP>1，P<0.05） between the two groups were found；These lipids belonged to categories of free fatty acid （FFA），triglyceride（TAG），diglyceride（DAG），cholesterol ester （CE）， ceramide（Cer），sphingomyelin（SM），phosphatidylcholine（PC），phosphatidylinositol（PI），lysophosphatidylcholine （LPC），ethanolamine plasmalogen（PlsEtn）；There were lower levels of CE，DAG，Cer，LPC，PlsEtn in CHB （decreased by 18%，17%，10%，32% and 29%，P<0.05）；TAG with higher carbon numbers and double bonds significantly decreased（P<0.05）；PC with lower double bonds significantly increased and PC with higher double bonds decreased （P<0.05）；The free monounsaturated fatty acids increased in CHB （increased by 36%，P<0.05） and were positively correlated with the METAVIR inflammation and fibrosis scores （Spearman correlation r=0.527，P<0.05 in activity，r=0.540，P<0.05 in fibrosis）. Conclusion The patients with CHB have numerous changes in lipid metabolism，and the lipidomic profiling may provide possible non-invasive method for the evaluation of hepatic injuries in patients with CHB.

Key words: Hepatitis B, Lipidomics, Ultra performance liquid chromatography tandem mass spectrometry