摘要目的:分析超重及肥胖体检人群定量CT所测体脂分布与血脂的相关性。方法:本研究为回顾性队列研究，采用整体抽样法选取2021年1—12月于河南省人民医院健康管理学科行胸部CT联合定量CT检查的3 463例体检人群为研究对象，根据体重指数18.5~<24.0 kg/m 2、24.0~<28.0 kg/m 2和≥28.0 kg/m 2分为正常组（1 424例）、超重组（1 531例）和肥胖组（508例）。收集3组一般资料、血脂指标和定量CT所测不同部位体脂分布（皮下脂肪面积、内脏脂肪面积、腹部总脂肪面积、肝脏脂肪含量、肌肉脂肪含量），采用单因素方差分析比较体脂分布及血脂指标差异，采用Pearson相关分析评估体脂分布与血脂的相关性。 结果:肥胖组皮下脂肪面积、内脏脂肪面积、腹部总脂肪面积、肝脏脂肪含量、肌肉脂肪含量、总胆固醇、低密度脂蛋白胆固醇（LDL-C）和甘油三酯均显著高于正常组和超重组［男性：（152.80±49.27）比（72.94±22.68）、（103.79±28.30）cm 2，（287.95±57.55）比（156.36±49.40）、（224.67±53.10）cm 2，（440.75±72.44）比（229.31±62.01）、（328.46±62.77）cm 2，（12.92±8.61）%比（6.82±3.31）%、（9.39±4.88）%，（9.06±9.34）%比（4.55±5.06）%、（6.70±6.73）%，（6.52±0.94）比（4.87±1.03）、（6.27±0.96）mmol/L，（3.05±0.76）比（2.92±0.86）、（2.97±0.77）mmol/L，（2.34±1.42）比（1.53±0.82）、（1.99±1.28）mmol/L；女性：（213.82±46.87）比（104.69±30.62）、（155.05±34.90）cm 2，（184.88±46.54）比（90.67±34.09）、（138.92±42.06）cm 2，（398.71±71.28）比（195.37±55.32）、（293.97±57.05）cm 2，（11.36±6.34）%比（5.51±3.02）%、（7.98±4.77）%，（7.44±7.60）%比（3.70±3.90）%、（5.56±5.94）%，（5.27±0.96）比（5.04±0.86）、（5.11±0.96）mmol/L，（3.26±0.84）比（2.92±0.79）、（3.01±0.74）mmol/L，（1.74±0.69）比（1.27±0.65）、（1.57±0.77）mmol/L］，高密度脂蛋白胆固醇（HDL-C）显著低于正常组和超重组［男性：（1.17±0.19）比（1.38±0.28）、（1.25±0.25）mmol/L；女性：（1.36±0.22）比（1.59±0.32）、（1.42±0.27）mmol/L］（均 P<0.001）。男性超重组内脏脂肪面积、腹部总脂肪面积均与甘油三酯呈正相关（ r=0.175、0.113），与HDL-C呈负相关（ r=-0.125、-0.113），肝脏脂肪含量与总胆固醇、LDL-C、甘油三酯均呈正相关（ r=0.083、0.075、0.206），与HDL-C呈负相关（ r=-0.093）（均 P<0.05）；肥胖组肝脏脂肪含量与甘油三酯呈正相关（ r=0.170），与HDL-C呈负相关（ r=-0.166）（均 P<0.05）。女性超重组内脏脂肪面积、腹部总脂肪面积均与总胆固醇、LDL-C、甘油三酯呈正相关（内脏脂肪面积： r=0.129、0.160、0.348；腹部总脂肪面积： r=0.121、0.130、0.283），与HDL-C呈负相关（ r=-0.264、-0.173），肝脏脂肪含量与甘油三酯呈正相关（ r=0.352），与HDL-C呈负相关（ r=-0.195）（均 P<0.05）；肥胖组内脏脂肪面积与甘油三酯呈正相关（ r=0.213），与HDL-C呈负相关（ r=-0.223）（均 P<0.05）。 结论:血脂与超重及肥胖体检人群体脂分布相关，其相关程度在不同性别和部位间存在差异，其中甘油三酯与肝脏脂肪含量的相关性最强。

abstractsObjective:To analyze the correlation between quantified body fat distribution measured by computed tomography (CT) and blood lipids in overweight and obese individuals undergoing physical examinations.Methods:In this retrospective cohort study, a total of 3 463 physical examination subjects who underwent chest CT combined with quantified CT examination in the Department of Health Management at Henan Provincial People′s Hospital from January to December 2021 were selected using a comprehensive sampling method. The subjects were divided into three groups: normal group (1, 424 cases), overweight group (1, 531 cases), and obese group (508 cases) based on their body mass index: 18.5 to <24.0 kg/m 2, 24.0 to <28.0 kg/m 2, and≥28.0 kg/m 2, respectively. General information, blood lipid parameters, and different body fat distributions measured by quantified CT (subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content) were collected in the three groups. One-way analysis of variance was used to compare differences in body fat distribution and blood lipid parameters, and Pearson correlation analysis was performed to evaluate the correlation between body fat distribution and blood lipids. Results:In the obese group, compared to the normal and overweight groups, subcutaneous fat area, visceral fat area, total abdominal fat area, liver fat content, muscle fat content, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels were significantly higher [males: (152.80±49.27) vs (72.94±22.68), (103.79±28.30) cm 2; (287.95±57.55) vs (156.36±49.40), (224.67±53.10) cm 2; (440.75±72.44) vs (229.31±62.01), (328.46±62.77) cm 2; (12.92±8.61)% vs (6.82±3.31)%, (9.39±4.88)%; (9.06±9.34)% vs (4.55±5.06)%, (6.70±6.73)%; (6.52±0.94) vs (4.87±1.03), (6.27±0.96) mmol/L; (3.05±0.76) vs (2.92±0.86), (2.97±0.77) mmol/L; (2.34±1.42) vs (1.53±0.82), (1.99±1.28) mmol/L; females: (213.82±46.87) vs (104.69±30.62), (155.05±34.90) cm 2; (184.88±46.54) vs (90.67±34.09), (138.92±42.06) cm 2; (398.71±71.28) vs (195.37±55.32), (293.97±57.05) cm 2; (11.36±6.34)% vs (5.51±3.02)%, (7.98±4.77)%; (7.44±7.60)% vs (3.70±3.90)%, (5.56±5.94)%; (5.27±0.96) vs (5.04±0.86), (5.11±0.96) mmol/L; (3.26±0.84) vs (2.92±0.79), (3.01±0.74) mmol/L; (1.74±0.69) vs (1.27±0.65), (1.57±0.77) mmol/L], while high-density lipoprotein cholesterol (HDL-C) was significantly lower [males: (1.17±0.19) vs (1.38±0.28), (1.25±0.25) mmol/L; females: (1.36±0.22) vs (1.59±0.32), (1.42±0.27) mmol/L] (all P<0.001). In males, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with triglycerides ( r=0.175, 0.113) and negatively correlated with HDL-C ( r=-0.125, -0.113), while liver fat content was positively correlated with total cholesterol, LDL-C, and triglycerides ( r=0.083, 0.075, 0.206) and negatively correlated with HDL-C ( r=-0.093) (all P<0.05). In the obese group, the liver fat content was positively correlated with triglycerides ( r=0.170) and negatively correlated with HDL-C ( r=-0.166) in males (both P<0.05). In females, the visceral fat area and total abdominal fat area in the overweight group were positively correlated with total cholesterol, LDL-C, and triglycerides (visceral fat area: r=0.129, 0.160, 0.348; total abdominal fat area: r=0.121, 0.130, 0.283) and negatively correlated with HDL-C ( r=-0.264, -0.173), while liver fat content was positively correlated with triglycerides ( r=0.352) and negatively correlated with HDL-C ( r=-0.195) (all P<0.05). In the obese group, the visceral fat area was positively correlated with triglycerides ( r=0.213) and negatively correlated with HDL-C ( r=-0.223) in females (both P<0.05). Conclusion:Blood lipids are correlated with body fat distribution in overweight and obese individuals undergoing physical examinations, and the degree of correlation varies between different genders and body regions, with triglycerides showing the strongest correlation with liver fat content.