目的　明确高血压患者腹部脂肪堆积与心脏重塑之间的关系。
方法　2006年1月－2008年12月收治的高血压患者380例，男198例，女182例，年龄21～83岁，采用螺旋CT进行腹部脂肪扫描，测量腹部内脏脂肪面积(VA)及腹壁脂肪面积(SA)，同时测量血压、腰围(WC)、体重指数(BMI)、心脏室间隔厚度(IVST)。根据VA和WC测量结果，将380例患者分为真性腹型肥胖组(VFO，n=128)，假性腹型肥胖组(Pseudo-VFO，n=83)，隐性腹型肥胖组(MVFO，n=68)及非肥胖组(Non-obesity，n=101)4组。根据IVST将患者分为IVST正常组和IVST增厚组。根据腹部脂肪测量结果将患者分为VA正常组和VA堆积组。分析不同组间IVST、SA、VA、VA/SA、WC、BMI的差异。
结果　IVST增厚组WC、VA、BMI、VA/SA明显高于IVST正常组，而SA明显低于IVST正常组(P<0.05)。VA堆积组IVST、WC、BMI、VA、VA/SA明显高于VA正常组，而SA明显低于VA正常组(P<0.05)。真性腹型肥胖组IVST、VA明显高于假性腹型肥胖组、隐性腹型肥胖组及非肥胖组(P<0.05)，而VA/SA比值低于隐性腹型肥胖组；隐性腹型肥胖组IVST、VA明显高于假性腹型肥胖组、非肥胖组(P<0.05)；假性腹型肥胖组SA高于真性腹型肥胖组、隐性腹型肥胖和非肥胖组(P<0.05)，而其IVST与非肥胖组比较无明显差异(P>0.05)。Logistic相关分析显示，VA/SA、VA、WC是导致IVST增厚的危险因素。
结论　隐性腹型肥胖与高血压患者室间隔肥厚明显相关。VA/SA是室间隔肥厚的重要危险因素。

Objective　To illustrate the relationship between abdominal fat accumulation and cardiac remodeling in hypertension patients. Methods　Visceral fat area (VA) and substantial fat area (SA) were assessed by CT in 380 hypertensive patients (male 198, female 182) with an age range of 21-83 years during the period of Jan 2006 to Dec 2008, and their blood pressure, waist circumference (WC), body mass index (BMI), interventricular septum thickness (IVST) were measured at the same time. The patients were divided into 4 groups according to their VA and WC, namely visceral fat obesity (VFO), pseudo-VFO, masked visceral fat obesity (MVFO), and non-obesity; intra-abdominal fat normal group (VA normal), intra-abdominal fat  accumulation group (IFA); interventricular septum thickening group, and normal group. The differences in IVST, SA, VA, VA/SA, WC and BMI were observed between the groups.
Results　The values of WC, VA, BMI, VA/SA were significantly higher in interventricular septum thickening group than in normal group, while the SA was significantly lower than that in normal group, and the difference was statistically significant (P<0.05). IVST, WC, BMI, VA and VA/SA were significantly higher in IFA group than in VA normal group, while SA was obviously higher in VA normal group, and showed statistically significant difference (P<0.05).
IVST and VA were significantly higher in VFO group than in other groups (P<0.05), and the VA/SA was significantly lower in VFO group than in MVFO group (P<0.05); the IVST and VA in MVFO group were significantly higher than those in pseudo-VFO group and non-obesity group (P<0.05). The SA in pseudo-VFO group was significantly higher than that in VFO, MVFO and non-obesity groups (P<0.05), however, there was no statistically significant difference in IVST when compared with non-obesity group. Logistic correlation analysis showed VA/SA, VA and WC were the risk factors leading to ventricular septal hypertrophy.
Conclusions  Masked abdominal obesity is significantly related to septal hypertrophy in hypertension, and VA/SA is an important risk factor for ventricular septal hypertrophy.