腹部脂肪和肝脏脂肪含量与骨密度相关性的定量CT分析

The study of correlation of abdominal adipose distribution,lipid content of liver and bone mineral density by quantitative CT

目的:探讨定量CT(QCT)测量不同性别和不同年龄组人群的腹部脂肪、肝脏脂肪含量及骨密度(BMD)之间的相关性。方法:选取1448例行低剂量胸部CT联合QCT检查的健康体检者,其中男532例,女916例,据年龄、性别、骨质疏松程度、脂肪肝程度分组,分别比较腹部脂肪、肝脏脂肪与BMD的相关性。结果:年龄与BMD之间呈显著负相关性(r=-0.642,P<0.001)。男脂肪肝患病率较女高(P<0.001),肝脏脂肪含量与BMD之间呈正相关(r=0.061,P=0.020),与腹部总脂肪(TAT)、内脏脂肪(VAT)、皮下脂肪(SAT)亦呈正相关,其中与TAT关系最紧密(r=0.768,P<0.001)。BMD与女VAT(r=-0.260,P<0.001)、TAT(r=-0.128,P<0.001)之间呈负相关,与男VAT之间亦存在负相关(r=-0.109,P=0.012)。结论:BMD随年龄增加而逐渐减低,而与肝脏脂肪含量之间可能存在一定的正相关。肝脏脂肪含量可能是BMD的保护因素,而VAT可能是BMD的负性影响因素。

Objective:To explore the correlation of abdominal adipose distribution,lipid content of liver and bone mineral density(BMD)by quantitative CT(QCT).Methods:1448 healthy individuals who underwent low-dose chest CT and QCT were enrolled,including 532 males and 916 females.They were divided according to age,sex,degree of osteoporosis and fatty liver.The correlation between abdominal adipose distribution,lipid content of liver and BMD was determined respectively.Results:There was a negative correlation between age and BMD(R=-0.642,P<0.001).The mean value of liver lipid content in male was significantly higher than that in female(P<0.001).There was a positive correlation between liver lipid content and BMD(R=0.061,P=0.020),and between liver lipid content and total adipose tissue(TAT),and between liver lipid content and visceral adipose tissue(VAT),and between liver lipid content and subcutaneous adipose tissue(SAT),among which the significant correlation was with TAT(R=0.768,P<0.001).For females,VAT(r=-0.260,P<0.001)and TAT(r=-0.128,P<0.001)were negatively correlated with BMD;for males,VAT was negatively correlated with BMD(r=-0.109,P=0.012).Conclusion:BMD decreased with age.BMD might be positively correlated with lipid content of liver.Lipid content of liver may be a protective factor for BMD,while VAT may be a negative factor.