Dataset Information

Associations of Residential Greenness with Diabetes Mellitus in Chinese Uyghur Adults.

ABSTRACT: Greenness exposure is nominated as a potential beneficial factor for health, but evidence is limited on its diabetes effects. We conducted a cross-sectional study between May and September 2016 in rural areas of northwestern China, including 4670 Uyghur adults, to explore the associations between residential greenness and fasting glucose levels and diabetes prevalence. Fasting glucose levels were determined, and information on covariates was collected by questionnaire. Normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI) were calculated to assess greenness levels. Generalized linear mixed models were applied to evaluate the associations of greenness with fasting glucose levels and diabetes prevalence. The prevalence of diabetes was 11.6%. We found that living in rural areas characterized by increased amounts of greenness was associated with reduced diabetes prevalence (e.g., NDVI1000m: OR, 0.92; 95% CI, 0.86, 0.99). Stratified analyses showed that the protective effects of greenness on diabetes prevalence were found only in women (NDVI1000m: OR, 0.90; 95% CI, 0.82, 0.99). However, none of the interaction was statistically significant. Our study suggests that greater residential greenness levels were associated with a lower odds ratio of diabetes prevalence in Xinjiang Uyghur adults. Further well-designed longitudinal studies are needed to confirm our findings.

SUBMITTER: Fan S

PROVIDER: S-EPMC6950214 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Associations of Residential Greenness with Diabetes Mellitus in Chinese Uyghur Adults.

Fan Shujun S Xue Zhenxiang Z Yuan Jun J Zhou Ziyan Z Wang Yuzhong Y Yang Zhicong Z Yang Boyi B Dong Guanghui G Zhang Zhoubin Z

International journal of environmental research and public health 20191216 24

Greenness exposure is nominated as a potential beneficial factor for health, but evidence is limited on its diabetes effects. We conducted a cross-sectional study between May and September 2016 in rural areas of northwestern China, including 4670 Uyghur adults, to explore the associations between residential greenness and fasting glucose levels and diabetes prevalence. Fasting glucose levels were determined, and information on covariates was collected by questionnaire. Normalized difference vege ...[more]

PMID: 31888136

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Project description:BackgroundGreenness exposure is beneficial to human health, but its potential mechanisms through which the risk for metabolic syndrome (MetS) could be reduced have been poorly studied. We aimed to estimate the greenness-MetS association in southeast China and investigate the independent and joint mediation effects of physical activity (PA), body mass index (BMI), and air pollutants on the association.MethodsA cross-sectional study was conducted among the 38,288 adults based on the Fujian Behavior and Disease Surveillance (FBDS), established in 2018. MetS was defined as the presence of three or more of the five components: abdominal obesity, elevated triglyceride, reduced high-density lipoprotein cholesterol (HDL-C), high blood pressure, and elevated fasting glucose. The residential greenness exposure was measured as the 3-year mean values of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) within the 250, 500, and 1,000 meters (m) buffer zones around the residential address of each participant. Logistic regression models were used to estimate the greenness-MetS association. The causal mediation analysis was used to estimate the independent and joint mediation effects of PA, BMI, particulate matter with an aerodynamic diameter of 2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2).ResultsEach interquartile range (IQR) increase in greenness was associated with a decrease of 13% (OR = 0.87 [95%CI: 0.83, 0.92] for NDVI500m and OR = 0.87 [95%CI: 0.82, 0.91] for EVI500m) in MetS risk after adjusting for covariates. This association was stronger in those aged < 60 years (e.g., OR = 0.86 [95%CI: 0.81, 0.92] for NDVI500m), males (e.g., OR = 0.73 [95%CI: 0.67, 0.80] for NDVI500m), having an educational level of primary school or above (OR = 0.81 [95%CI: 0.74, 0.89] for NDVI500m), married/cohabitation (OR = 0.86 [95%CI: 0.81, 0.91] for NDVI500m), businessman (OR = 0.82 [95%CI: 0.68, 0.99] for NDVI500m), other laborers (OR = 0.77 [95%CI: 0.68, 0.88] for NDVI500m), and non-smokers (OR = 0.77 [95%CI: 0.70, 0.85] for NDVI500m). The joint effect of all six mediators mediated about 48.1% and 44.6% of the total effect of NDVI500m and EVI500m on the MetS risk, respectively. Among them, BMI showed the strongest independent mediation effect (25.0% for NDVI500m), followed by NO2 and PM10.ConclusionExposure to residential greenness was associated with a decreased risk for MetS. PA, BMI, and the four air pollutants jointly interpreted nearly half of the mediation effects on the greenness-MetS association.

Project description:ImportanceLiving in areas with more vegetation (referred to as residential greenness) may be associated with cardiovascular disease (CVD), but little data are available from low- and middle-income countries. In addition, it remains unclear whether the presence of cardiometabolic disorders modifies or mediates the association between residential greenness and CVD.ObjectiveTo evaluate the associations between residential greenness, cardiometabolic disorders, and CVD prevalence among adults in China.Design, setting, and participantsThis analysis was performed as part of the 33 Communities Chinese Health Study, a large population-based cross-sectional study that was conducted in 33 communities (ranging from 0.25-0.64 km2) in 3 cities within the Liaoning province of northeastern China between April 1 and December 31, 2009. Participants included adults aged 18 to 74 years who had resided in the study area for 5 years or more. Greenness levels surrounding each participant's residential community were assessed using the normalized difference vegetation index and the soil-adjusted vegetation index from 2010. Lifetime CVD status (including myocardial infarction, heart failure, coronary heart disease, cerebral thrombosis, cerebral hemorrhage, cerebral embolism, and subarachnoid hemorrhage) was defined as a self-report of a physician diagnosis of CVD at the time of the survey. Cardiometabolic disorders, including hypertension, diabetes, dyslipidemia, and overweight or obese status, were measured and defined clinically. Generalized linear mixed models were used to evaluate the association between residential greenness levels and CVD prevalence. A 3-way decomposition method was used to explore whether the presence of cardiometabolic disorders mediated or modified the association between residential greenness and CVD. Data were analyzed from October 10 to May 30, 2020.Main outcomes and measuresLifetime CVD status, the presence of cardiometabolic disorders, and residential greenness level.ResultsAmong 24 845 participants, the mean (SD) age was 45.6 (13.3) years, and 12 661 participants (51.0%) were men. A total of 1006 participants (4.1%) reported having a diagnosis of CVD. An interquartile range (1-IQR) increase in the normalized difference vegetation index within 500 m of a community was associated with a 27% lower likelihood (odds ratio [OR], 0.73; 95% CI, 0.65-0.83; P < .001) of CVD prevalence, and an IQR increase in the soil-adjusted vegetation index within 500 m of a community was associated with a 26% lower likelihood (OR, 0.74; 95% CI, 0.66-0.84; P < .001) of CVD prevalence. The presence of cardiometabolic disorders was found to mediate the association between residential greenness and CVD, with mediation effects of 4.5% for hypertension, 4.1% for type 2 diabetes, 3.1% for overweight or obese status, 12.7% for hypercholesterolemia, 8.7% for hypertriglyceridemia, and 11.1% for high low-density lipoprotein cholesterol levels.Conclusions and relevanceIn this cross-sectional study, higher residential greenness levels were associated with lower CVD prevalence, and this association may be partially mediated by the presence of cardiometabolic disorders. Further studies, preferably longitudinal, are warranted to confirm these findings.

Project description:BackgroundStudies of effects of air pollution on gestational diabetes mellitus (GDM) have not been consistent, and there has been little investigation of effects of exposure preceding pregnancy. In previous studies, the temporal relationship between exposure and GDM onset has been difficult to establish.MethodsData were obtained for 239,574 pregnancies between 1999 and 2009 in a population-based health care system with comprehensive electronic medical records. Concentrations of ambient nitrogen dioxide (NO2), particulate matter (PM) ≤2.5 μm in aerodynamic diameter (PM2.5) and ≤10 μm (PM10), and ozone (O3) during preconception and the first trimester of pregnancy at the residential birth address were estimated from regulatory air monitoring stations. Odds ratios (ORs) of GDM diagnosed in the second and third trimesters in association with pollutant exposure were estimated using generalized estimating equation models adjusted for birth year, medical center service areas, maternal age, race/ethnicity, education, census-tract household income, and parity.ResultsIn single-pollutant models, preconception NO2 was associated with increased risk of GDM (OR = 1.10 per 10.4 ppb, 95% confidence interval [CI]: 1.07, 1.13). First trimester NO2 was weakly associated with GDM, and this was not statistically significant (OR = 1.02 per 10.4 ppb, 95% CI: 0.99, 1.05). Preconception NO2 associations were robust in multi-pollutant models adjusted for first trimester NO2 with another co-pollutant from both exposure windows. In single-pollutant models, preconception PM2.5 and PM10 associations were associated with increased risk of GDM (OR = 1.04 per 6.5 μg/m3, 95% CI: 1.01, 1.06; OR = 1.03 per 16.1 μg/m3, 95% CI: 1.00, 1.06, respectively), but these effect estimates were not robust to adjustment for other pollutants. In single-pollutant models, preconception and first trimester O3 were associated with reduced risk of GDM (OR = 0.94 per 15.7 ppb, 95% CI: 0.92, 0.95; OR = 0.95 per 15.7 ppb, 95% CI: 0.94, 0.97), associations that were robust to adjustment for co-pollutants.ConclusionsMaternal exposure to NO2 during the preconception trimester may increase risk of GDM.

Project description:BackgroundWe hypothesize higher air pollution and fewer greenness exposures jointly contribute to metabolic syndrome (MetS), as mechanisms on cardiometabolic mortality.MethodsWe studied the samples in the Chinese Longitudinal Healthy Longevity Survey. We included 1755 participants in 2012, among which 1073 were followed up in 2014 and 561 in 2017. We used cross-sectional analysis for baseline data and the generalized estimating equations (GEE) model in a longitudinal analysis. We examined the independent and interactive effects of fine particulate matter (PM2.5) and Normalized Difference Vegetation Index (NDVI) on MetS. Adjustment covariates included biomarker measurement year, baseline age, sex, ethnicity, education, marriage, residence, exercise, smoking, alcohol drinking, and GDP per capita.ResultsAt baseline, the average age of participants was 85.6 (SD: 12.2; range: 65-112). Greenness was slightly higher in rural areas than urban areas (NDVI mean: 0.496 vs. 0.444; range: 0.151-0.698 vs. 0.133-0.644). Ambient air pollution was similar between rural and urban areas (PM2.5 mean: 49.0 vs. 49.1; range: 16.2-65.3 vs. 18.3-64.2). Both the cross-sectional and longitudinal analysis showed positive associations of PM2.5 with prevalent abdominal obesity (AO) and MetS, and a negative association of NDVI with prevalent AO. In the longitudinal data, the odds ratio (OR, 95% confidence interval-CI) of PM2.5 (per 10 μg/m3 increase) were 1.19 (1.12, 1.27), 1.16 (1.08, 1.24), and 1.14 (1.07, 1.21) for AO, MetS and reduced high-density lipoprotein cholesterol (HDL-C), respectively. NDVI (per 0.1 unit increase) was associated with lower AO prevalence [OR (95% CI): 0.79 (0.71, 0.88)], but not significantly associated with MetS [OR (95% CI): 0.93 (0.84, 1.04)]. PM2.5 and NDVI had a statistically significant interaction on AO prevalence (pinteraction: 0.025). The association between PM2.5 and MetS, AO, elevated fasting glucose and reduced HDL-C were only significant in rural areas, not in urban areas. The association between NDVI and AO was only significant in areas with low PM2.5, not under high PM2.5.ConclusionsWe found air pollution and greenness had independent and interactive effect on MetS components, which may ultimately manifest in pre-mature mortality. These study findings call for green space planning in urban areas and air pollution mitigation in rural areas.

Dataset Information

Associations of Residential Greenness with Diabetes Mellitus in Chinese Uyghur Adults.

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Associations of Residential Greenness with Diabetes Mellitus in Chinese Uyghur Adults.

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