Associations between regional fat distribution and remnant cholesterol in postmenopausal women: a QCT and MRI mDIXON-Quant Study

This study aimed to explore depot-specific associations between regional fat distribution and remnant cholesterol (RC), a key cardiovascular risk marker, in postmenopausal women using quantitative computed tomography (QCT) and MRI mDIXON-Quant. A total of 107 postmenopausal women were included. RC was calculated from routine serum lipid parameters. Correlation, regression and restricted cubic spline (RCS) analyses were applied to evaluate linear and non-linear relationships. H‑PDFF was positively correlated with RC ( r = 0.284, P = 0.003), while no significant linear correlations were observed for L-BMFF, P-PDFF, VFM, or SFM. After adjustment for age and BMI, no significant non‑linear relationships were observed between these fat measures and RC (all P -values for non‑linearity > 0.05). Multivariable regression confirmed that H‑PDFF was an independent positive correlate of RC ( B = 0.022, 95% CI: 0.009–0.034, P = 0.001). These findings provide supplementary imaging evidence for the differential associations of regional fat depots with remnant cholesterol, and warrant further validation in larger cohorts.