【摘要】 目的 探讨中老年人群血浆致动脉粥样硬化指数（AIP）、尿酸/高密度脂蛋白胆固醇比值（UHR）与定量CT(QCT)技术测定的体脂肪分布[内脏脂肪面积（VFA）、皮下脂肪面积（SFA）、肝脏脂肪含量（LFC）]的相关性。方法回顾性选取2020年1月至2024年8月行QCT检查的中老年体检者为研究对象，搜集其一般资料与临床资料；采用QCT技术测量受试者VFA、SFA及LFC。根据性别分为男性组和女性组。采用独立样本t检验和Mann-Whitney U检验比较不同性别中老年人群一般资料与临床资料。采用单因素线性回归分析评估AIP、UHR与体脂肪分布的相关性并筛选所有纳入多重线性回归模型的协变量。采用分层方式逐步纳入协变量，以VFA、SFA、LFC分别为因变量，AIP、UHR分别为自变量，构建多重线性回归模型，分别评估AIP、UHR与体脂肪分布的独立关联。结果 按性别分组比较显示，男性的年龄、体重指数（BMI）、甘油三酯（TG）、尿酸（UA）、AIP、UHR、VFA、LFC水平均显著高于女性，而女性的总胆固醇（TC）、低密度脂蛋白胆固醇（LDL??-C）、高密度脂蛋白胆固醇（HDL??-C）、SFA更高（P均<0.05）。多重线性回归分析显示：AIP与VFA在三模型中均呈显著正相关（模型1:B=126.256,Beta=0.439；模型2:B=95.623,Beta=0.333；模型3:B=38.932,Beta=0.136;P均<0.05）；与SFA的关联呈动态变化，模型1、2中呈正相关（B=16.733、34.555,Beta=0.100、0.206），模型3中转为微弱负相关（B=-3.654,Beta=-0.022,P<0.05）；与LFC在三模型中均呈显著正相关（模型1:B=5.939,Beta=0.326；模型2:B=5.670,Beta=0.311；模型3:B=3.253,Beta=0.178;P均<0.05）。UHR与VFA在三模型中均呈显著正相关（模型1:B=972.261,Beta=0.529；模型2:B=607.304,Beta=0.331；模型3:B=147.274,Beta=0.080;P均<0.05）；与SFA的关联呈动态变化，模型1中无显著关联（B=-1.484,Beta=-0.001,P=0.890），模型2中呈显著正相关（B=271.198,Beta=0.253），模型3中转为微弱正相关（B=27.251,Beta=0.025,P<0.05）；与LFC在三模型中均呈显著正相关（模型1:B=36.277,Beta=0.311；模型2:B=36.458,Beta=0.313；模型3:B=17.489,Beta=0.150;P均<0.05）。结论 中老年人群AIP、UHR与VFA、LFC均存在稳定正相关，且在调整多协变量后关联仍显著；两者与SFA的关联受年龄、性别、BMI等因素调控呈动态变化。QCT技术可精准量化体脂分布，AIP、UHR或可作为中老年人群内脏脂肪堆积与肝脏脂肪沉积的无创评估参考指标。更多还原

【Abstract】 Objective To investigate the correlation between atherogenic index of plasma(AIP),uric acid/high-density lipoprotein cholesterol ratio(UHR),and fat distribution(visceral fat area VFA,subcutaneous fat area SFA,liver fat content LFC)measured by quantitative computed tomography(QCT)in middle-aged and elderly populations.Method A retrospective cohort study was conducted involving a middle-aged and elderly population who underwent QCT examinations at the Health Management Centre of Henan Provincial People’ s Hospital between January 2020 and August 2024.General and clinical data were collected.QCT technology was employed to measure participants ’ VFA,SFA,and LFC.Participants were categorised into male and female groups based on gender.Independent samples t-tests and Mann-Whitney U tests were employed to compare general and clinical data between genders.Univariate linear regression analysis was used to assess correlations between AIP,UHR,and fat distribution,and to screen covariates for inclusion in multiple linear regression models.Covariates were progressively incorporated using a stratified approach.Multiple linear regression models were constructed with VFA,SFA,and LFC as dependent variables and AIP and UHR as independent variables,respectively,to evaluate the independent associations between AIP,UHR,and fat distribution.Results Comparisons by gender revealed that males exhibited significantly higher levels of age,body mass index(BMI),triglycerides(TG),uric acid(UA),AIP,UHR,VFA,and LFC levels were significantly higher than those in females,whereas females exhibited higher levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and SFA(all P<0.05).Multiple linear regression analysis revealed:AIP exhibited significant positive correlations with VFA across all three models(Model 1:B=126.256,Beta=0.439;Model 2:B=95.623,Beta=0.333;Model 3:B=38.932,Beta=0.136;all P<0.05);The relationship with SFA exhibited dynamic variation,showing positive correlations in Models 1 and 2(B=16.733,34.555;Beta=0.100,0.206),but shifting to a weak negative correlation in Model 3(B=-3.654;Beta=-0.022;P<0.05);A significant positive correlation with LFC was observed across all three models(Model 1:B=5.939,Beta=0.326;Model 2:B=5.670,Beta=0.311;Model 3:B=3.253,Beta=0.178;all P<0.05).UHR and VFA exhibited significant positive correlations in all three models(Model 1:B=972.261,Beta=0.529;Model 2:B=607.304,Beta=0.331;Model 3:B=147.274,Beta=0.080;all P<0.05).The association with SFA exhibited dynamic changes:no significant association in Model 1(B=-1.484,Beta=-0.001,P=0.890),a significant positive correlation in Model 2(B=271.198,Beta=0.253),and a weak positive correlation in Model3(B=27.251,Beta=0.025,P<0.05).Model 2:B=36.458,Beta=0.313;Model 3:B=17.489,Beta=0.150;all P<0.05).Conclusion AIP and UHR in the middle-aged and elderly population exhibit stable positive correlations with both VFA and LFC,with these associations remaining significant after adjusting for multiple covariates.Their relationship with SFA undergoes dynamic changes modulated by factors such as age,gender,and BMI.QCT technology enables precise quantification of fat distribution,suggesting AIP and UHR may serve as non-invasive reference indicators for assessing visceral fat accumulation and hepatic fat deposition in this demographic.更多还原