Background: Methods: This cross-sectional study retrospectively analyzed data from 9,218 patients who underwent physical examinations at Shanghai Health and Medical Center in 2022. HP infection status was determined using the carbon-13 breath test, and clinical data, biochemical indicators, and lipid metabolism-related data were collected. Multiple regression analysis was employed to investigate the relationship between HP infection and the ApoB/ApoA1 ratio. Results: Patients in the HP-positive group were older and had a higher proportion of males. Their body mass index (BMI), blood pressure, γ-glutamyl transpeptidase (γ-GT), total cholesterol (TC), fasting blood glucose (FBG), Creatinine and White blood Cell were significantly higher than those in the HP-negative group. The HP-positive group exhibited a higher prevalence of underlying diseases (e.g., hypertension, diabetes, coronary heart disease) and significant abnormalities in glucose and lipid metabolism, uric acid, high-sensitivity C-reactive protein (hs-CRP), and other indicators. The ApoB/ApoA1 ratio was significantly elevated in the HP-positive group and was not influenced by gender. Multiple regression analysis revealed that the ApoB/ApoA1 ratio is an independent risk factor for HP infection. Conclusion: HP infection is closely associated with abnormal lipid metabolism, and the ApoB/ApoA1 ratio is an independent risk factor for HP infection, demonstrating significant advantages over other lipid indicators. This large-scale study highlights a significant association between HP infection and an elevated ApoB/ApoA1 ratio. The findings suggest that HP may contribute to cardiovascular risk via dyslipidemia, with the ApoB/ApoA1 ratio serving as a potential biomarker. Further research should explore whether HP eradication could mitigate these metabolic disturbances.