CT腹部脂肪定量测量与腹主动脉钙化相关性的研究

Association of Abdominal Aortic Calcifification with Fat Quantification Based on CT

目的探讨腹主动脉钙化严重程度与腹部内脏脂肪的相关性。方法搜集临床病史资料齐全并接受全腹及盆腔CT平扫的166例受试者。根据腹主动脉钙化(AAC)积分将受试者分为三组(无钙化组、轻度钙化组、重度钙化组),采用组内相关性检验(ICC检验)和Kappa一致性检验分别评估2名影像医师对腹部脂肪测量和腹主动脉钙化分级的一致性,采用独立样本t检验和多因素Logistic回归分析ACC积分与腹部脂肪的关系。结果2名影像医师对腹部脂肪测量(ICC均>0.833)和腹主动脉钙化分级(k=0.86)具有较高一致性。L3~4椎体中间层面的内脏脂肪面积(VFA)对腹腔总体内脏脂肪体积(VFV)具有代表性(r=0.838,P<0.001)。重度钙化组VFA占比(VFA%)显著高于无钙化组(P<0.01)。年龄(OR=3.803 P<0.01)、VFA%(OR=1.728 P<0.05)、血脂异常(OR=3.08 P<0.05)是腹主动脉钙化的独立危险因素。结论腹主动脉钙化严重程度与腹部内脏脂肪显著相关。

Objectivee To investigate the correlation between the severity of abdominal aortic calcification and abdominal visceral fat.Methods A total of 166 subjects who had complete clinical history and underwent CT scan of whole abdomen and pelvis were analyzed retrospectively.According to the abdominal aortic calcification score(AAC),the subjects were divided into three groups(non-calcification group,mild-calcification group and severe-calcification group).Intraclass correlation coefficient(ICC)and Kappa test were used to evaluate the consistency of abdominal fat measurement and abdominal aortic calcification grade by two radiologists.Independent sample t-test and multivariate Logistic regression were used to analyze the relationship between abdominal fat and abdominal aortic calcification score.Results Two radiologists had high consistency in the measurement of abdominal fat(ICC>O.833)and abdominal aortic calcification grade(k=0.86).The visceral fat area(VFA)in the middle layer of L3-4 vertebral body was representative to the total visceral fat volume(VFV)of abdominal cavity(r=0.838,P<0.001).The percentage of VFA(VFA%)in severe-calcification group was significantly higher than that in none-calcification group(P<0.01).Multivariate Logistic regression analysis showed that age(OR=3.803 P<001),VFA%(OR=1.728 P<005)and dyslipidemia(OR=3.08 P<005)were independent risk factors for abdominal aortic calcification.Conciusion The severity of abdominal aortic calcification was significantly correlated with the abdominal visceral fat.