Abstract: Objective To investigate the association between serum miR-122 levels and the severity of liver fibrosis in hepatitis B-related cirrhotic (HBV-LC) patients. Methods A total of 98 blood samples were collected from HBV-LC patients from May 2022 to December 2023, forming the HBV-LC group. Meanwhile, blood samples from 40 healthy individuals were collected as the control group. Serum miR-122 expression levels and liver biochemical markers were tested in all participants. The HBV-LC group was divided into stage S0 (19 cases), S1 (22 cases), S2 (23 cases), S3 (18 cases), and S4 (16 cases) based on the degree of liver fibrosis. The differences in miR-122 and liver biochemical markers across different stages were compared. The correlation between serum miR-122 levels and fibrosis markers were analyzed. A logistic regression model was used to analyze the risk factors for liver fibrosis in the HBV-LC group, and a ROC curve was constructed. Results In the HBV-LC group, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alpha-fetoprotein (AFP), gamma-glutamyltransferase (GGT), and the expression level of miR-122 were (59.80±13.60) U/L, (67.89±14.94) U/L, (19.07±4.20) μmol/L, (13.06±3.88) ng/mL, (76.46±20.31) U/L, and (4.03±1.38), respectively, which were significantly higher than those of (23.23±5.17) U/L, (21.22±4.98) U/L, (11.33±3.05) μmol/L, (3.54±1.12) ng/mL, (29.81±7.28) U/L, (1.25±0.37) in the control group (P<0.05). With the progression of liver fibrosis stages, the levels of ALT, AST, TBil, AFP, GGT increased, whereas the miR-122 expression decreased (P<0.05). Serum miR-122 expression levels in the HBV-LC group were negatively correlated with AFP, AST, ALT, GGT, Fibrosis-4 Index (FIB-4), AST to Platelet Ratio Index (APRI), TBIL, and Forns index (P<0.05). The result of Logistic regression analysis indicated that alcohol consumption and lower serum miR-122 expression levels are risk factors for liver fibrosis in HBV-LC patients (P<0.05). The ROC curve analysis demonstrated that miR-122 expression levels have a high diagnostic efficiency for liver fibrosis (S1~S4) with an area under the curve of 0.939, a sensitivity of 94.7%, and a specificity of 91.1%. Conclusion The study shows that serum miR-122 levels decrease as liver fibrosis worsen in patients with hepatitis B virus-related cirrhosis and are significantly correlated with liver biochemical markers and fibrosis markers. Alcohol consumption and low serum miR-122 expression are important risk factors for the progression of liver fibrosis. Therefore, serum miR-122 expression levels may serve as an effective biomarker for assessing the degree of liver fibrosis in patients with HBV-LC and predicting disease progression, thus offering significant clinical application value.

Key words: Hepatitis B, Cirrhosis, miR-122, Liver fibrosis