〔Abstract〕 Objective To investigate the metabolic changes of early hepatocellular carcinoma in patients with cirrhosis caused by viral hepatitis and its relationship with aging and enzyme activity. Methods According to the diagnosis results, a total of 140 patients were divided into liver cirrhosis group(LC group),hepatocellular carcinoma with liver cirrhosis group(CLH group),early hepatocellular carcinoma group(HCC group) and control group, with 35 cases in each group.The proton magnetic resonance spectroscopy(1H-MRS) was used to measure liver cell metabolite levels, and the generalized estimating equation was used to analyze potential risk factors for changes in metabolite levels. Results Serum alkaline phosphatase(ALP) levels in the LC group, serum aspartate aminotransferase(AST),lactate dehydrogenase(LDH),ALP,and glucose levels in the CLH group were higher than those in the control group(P<0.05),and the serum AST and glucose levels in the CLH group were higher than those in the LC group(P<0.05).The levels of lactic acid and triglycerides(Lac+TG)(1.3 ppm) in LC group and CLH group were lower than those in control group and HCC group(P<0.05).The level of choline(Cho)(3.2 ppm) in the CLH group was higher than that in the control group(P<0.05),and the level of Cho(3.2 ppm) in the HCC group was higher than that in the control, LC and CLH groups(P<0.05).The levels of triglycerides(TG)(0.9 ppm) and TG(2.1 ppm) in the LC,CLH and HCC groups were lower than those in the control group(P<0.05).In the LC,CLH and HCC groups, the Lac+TG(1.3 ppm) level was positively correlated with age, LDH,and the Cho(3.2 ppm) level was positively correlated with ALP(r=0.340,P=0.002).The related risk factors for changes in Lac+TG and Cho metabolism were age 60-80 years.The results of interaction analysis showed that Lac+TG levels were related to HCC in men or women aged 40 to 50,and LC,CLH,HCC in men or women aged 60 to 80(P<0.05).The Cho level was related to HCC in men or women aged 60 to 80(P<0.05). Conclusion The high levels of Lac+TG and Cho may be related to the metabolic changes of early hepatocellular carcinoma in patients with cirrhosis caused by viral hepatitis.In addition, the level of Lac+TG in hepatocellular carcinoma is positively correlated with older age and LDH.