Long-term exposure to residential surrounding greenness and incidence of diabetes: A prospective cohort study. (1st October 2022)

• Record Type: Journal Article
• Authors: Yu, Luhua; Li, Tiezheng; Yang, Zongming; Zhang, Xinhan; Xu, Lisha; Wu, Yonghao; Yu, Zhebin; Shen, Peng; Lin, Hongbo; Shui, Liming; Tang, Mengling; Jin, Mingjuan; Chen, Kun; Wang, Jianbing
• Is Part Of: Environmental pollution. Volume 310(2022)
• Publication Date: 2022-10-01
• Subjects: Diabetes -- Greenness -- Cohort study -- Long-term exposure; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2022.119821
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: Exposure to residential greenness might affect population health through increasing physical activity and social engagement, improving mental health, and reducing harmful environmental exposure. However, evidence on the association of greenness with risk of diabetes is still controversial. In this study, we recruited a total of 22, 535 participants aged ≥18 years from Yinzhou District, Ningbo, Zhejiang Province, China to investigate the associations between residential greenness and risk of diabetes incidence. Residential greenness was estimated using Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), and Vegetation Continuous Field (VCF). We also calculated cumulative average NDVI, EVI and VCF values, and changes in NDVI, EVI and VCF during the follow-up period. We used Cox proportional hazards models controlling for demographic characteristics, lifestyles, individual socioeconomic status, history of diseases and particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5 ) to examine hazard ratios (HRs) and 95% confidence intervals (95% CIs) and assessed physical activity, body mass index (BMI) or PM2.5 as potential mediators. During 84, 992.64 person-years of follow-up, a total of 1, 154 incident cases of diabetes occurred. In multivariable models, living in the highest quartile of cumulative average NDVI, EVI and VCF within 250-m buffer was associated with 57% (HR = 0.43, 95% CI: 0.36, 0.52), 62% (HR = 0.38, 95% CI: 0.32, 0.45), and 55% (HR = 0.45, 95% CI: 0.38, 0.54) reduction in diabetes risk compared with the lowest quartile, respectively. Results remained similar for NDVI, EVI, and VCF within 500-m and 1000-m buffers. Stratified analyses showed stronger association for residential greenness and diabetes among older people. The association between greenness and diabetes did not appear to be mediated by physical activity, PM2.5 or BMI. Our findings suggested that higher residential greenness was significantly associated with lower risk of diabetes. Graphical abstract: Image 1 Highlights: New evidence on the association between greenness and diabetes from China. A prospective cohort study was conducted in 22, 535 adults in China during 2015–2020. Higher residential greenness was associated with lower risk of diabetes. Stronger inverse association was observed among older people.