目的 研究在不同指南推荐甘油三酯水平下残余胆固醇（remnant cholesterol，RC）与代谢相关脂肪性肝病（metabolic-associated fatty liver disease，MAFLD）发病风险的关系。 方法 研究数据来源于2023年某社区体检的65岁及以上的老年人数据。使用回归分析评估整体人群RC与MAFLD风险的关系。依据中国血脂管理指南推荐的甘油三酯合适水平（< 1.7 mmol/L）及欧洲动脉粥样硬化学会提出的甘油三酯理想目标（< 1.2 mmol/L），将人群划分为不同甘油三酯水平的亚组，研究不同甘油三酯水平分层中RC与MAFLD风险的关联度。 结果 本次研究共纳入2 800名年龄在65岁及以上老年人。MAFLD发病率为20.85%。RC是MAFLD风险的独立影响因子（P < 0.001）。在甘油三酯 < 1.7 mmol/L的老年个体中，RC水平与MAFLD发病风险相关性不显著（P = 0.888）；在甘油三酯≥ 1.7 mmol/L的老年个体中，RC水平与MAFLD发病风险显著正相关（P < 0.001）；交互检验显示分层因素对RC的效应量无显著交互作用（P = 0.115）。在甘油三酯< 1.2 mmol/L的老年个体中，RC水平与MAFLD发病风险不相关（P = 0.505）；而甘油三酯≥ 1.2 mmol/L的老年个体中，RC水平与MAFLD发病风险显著相关（P < 0.001）；交互检验显示分层因素对RC的效应量有显著交互作用（P = 0.011）。 结论 RC是老年MAFLD风险的独立影响因子。为降低老年人RC相关的MAFLD风险，甘油三酯＜1.2 mmol/L可作为识别早期风险的参考依据。

Objective This study aims to investigate the association between remnant cholesterol （RC） and the risk of metabolic-associated fatty liver disease （MAFLD） under the optimal triglyceride （TG） levels recommended by different guidelines. Methods The data were derived from the annual physical examinations of elderly people aged 65 and above in a community in 2023. Regression analysis was used to evaluate the association between RC and MAFLD risk. According to the TG normal level （< 1.7 mmol/L） recommended by the Chinese Lipid Management Consensus and the TG ideal target （< 1.2 mmol/L） proposed by the European Atherosclerosis Society， the individuals were divided into subgroups with different TG levels to explore the association between RC and MAFLD risk in each subgroup. Results A total of 2，800 elderly individuals aged 65 and above were included in this study. The proportion of the individuals meeting the diagnostic criteria for MAFLD was 20.85%， and RC was identified as an independent risk factor for MAFLD （P < 0.001）. In the elderly individuals with TG< 1.7 mmol/L， RC level was not significantly associated with MAFLD risk （P = 0.888）. In contrast， in the elderly individuals with TG ≥ 1.7 mmol/L， RC level was significantly and positively correlated with MAFLD risk （P < 0.001）. Interaction tests revealed no significant interaction between the stratification factor and the effect size of RC （P = 0.115）. In the elderly individuals with TG< 1.2 mmol/L， RC level was not associated with MAFLD risk（P = 0.505）， while in the elderly individuals with TG ≥ 1.2 mmol/L， RC level was significantly associated with MAFLD risk （P < 0.001）. Interaction tests showed a significant interaction between the stratification factor and the effect size of RC （P = 0.011）. Conclusion RC is an independent risk factor for MAFLD in older individuals. To reduce the risk of MAFLD related to RC in the elderly， a triglyceride level of < 1.2 mmol/L can serve as a reference for identifying early-stage risk.