TY - JOUR
T1 - Associations of greenness with diabetes mellitus and glucose-homeostasis markers
T2 - The 33 Communities Chinese Health Study
AU - Yang, Bo Yi
AU - Markevych, Iana
AU - Heinrich, Joachim
AU - Bowatte, Gayan
AU - Bloom, Michael S.
AU - Guo, Yuming
AU - Dharmage, Shyamali C.
AU - Jalaludin, Bin
AU - Knibbs, Luke D.
AU - Morawska, Lidia
AU - Qian, Zhengmin (Min)
AU - Chen, Duo Hong
AU - Ma, Huimin
AU - Chen, Da
AU - Lin, Shao
AU - Yang, Mo
AU - Liu, Kang Kang
AU - Zeng, Xiao Wen
AU - Hu, Li Wen
AU - Dong, Guang Hui
N1 - Publisher Copyright:
© 2018
PY - 2019/3
Y1 - 2019/3
N2 - Background: Residing in greener places may be protective against diabetes mellitus (DM) but evidence is scarce and comes mainly from developed countries. Objectives: To investigate associations of residential greenness with DM prevalence and glucose-homeostasis markers in Chinese adults and whether these associations were mediated by air pollution, physical activity, and body mass index. Methods: In 2009, a total of 15,477 adults from the cross-sectional 33 Communities Chinese Health Study provided blood samples and completed a questionnaire. We considered fasting and 2-h glucose and insulin concentrations, as well as the homoeostasis model assessment of insulin resistance and β-cell function, as glucose-homeostasis markers. DM was defined according to the American Diabetes Association's recommendations. Residential greenness was estimated by two satellite-derived vegetation indexes – Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI). Nitrogen dioxide and particulate matter ≤2.5 μm were used as air pollution proxies. Associations were assessed by two-level adjusted logistic and linear regression models. Results: A 0.1-unit increase in NDVI 500 m and SAVI 500 m was significantly associated with lower odds of DM by factors of 0.88 (95% Confidence Interval 0.82–0.94) and 0.80 (0.72–0.90), respectively. Higher greenness was also significantly associated with lower fasting and 2-h glucose levels, 2-h insulin level, as well as lower insulin resistance and higher β-cell function. Air pollution and body mass index significantly mediated 6.9–51.1% and 8.6–78.7% these associations, respectively, while no mediation role was observed for physical activity. Conclusions: Higher residential greenness appears to be associated with a lower prevalence of DM. This association might be due to glucose and insulin metabolism and pancreatic β-cell function. Lower levels of air pollution and body mass index can be pathways linking greenspace to diabetes.
AB - Background: Residing in greener places may be protective against diabetes mellitus (DM) but evidence is scarce and comes mainly from developed countries. Objectives: To investigate associations of residential greenness with DM prevalence and glucose-homeostasis markers in Chinese adults and whether these associations were mediated by air pollution, physical activity, and body mass index. Methods: In 2009, a total of 15,477 adults from the cross-sectional 33 Communities Chinese Health Study provided blood samples and completed a questionnaire. We considered fasting and 2-h glucose and insulin concentrations, as well as the homoeostasis model assessment of insulin resistance and β-cell function, as glucose-homeostasis markers. DM was defined according to the American Diabetes Association's recommendations. Residential greenness was estimated by two satellite-derived vegetation indexes – Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI). Nitrogen dioxide and particulate matter ≤2.5 μm were used as air pollution proxies. Associations were assessed by two-level adjusted logistic and linear regression models. Results: A 0.1-unit increase in NDVI 500 m and SAVI 500 m was significantly associated with lower odds of DM by factors of 0.88 (95% Confidence Interval 0.82–0.94) and 0.80 (0.72–0.90), respectively. Higher greenness was also significantly associated with lower fasting and 2-h glucose levels, 2-h insulin level, as well as lower insulin resistance and higher β-cell function. Air pollution and body mass index significantly mediated 6.9–51.1% and 8.6–78.7% these associations, respectively, while no mediation role was observed for physical activity. Conclusions: Higher residential greenness appears to be associated with a lower prevalence of DM. This association might be due to glucose and insulin metabolism and pancreatic β-cell function. Lower levels of air pollution and body mass index can be pathways linking greenspace to diabetes.
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U2 - 10.1016/j.ijheh.2018.12.001
DO - 10.1016/j.ijheh.2018.12.001
M3 - Article
C2 - 30545606
AN - SCOPUS:85057981937
SN - 1438-4639
VL - 222
SP - 283
EP - 290
JO - International Journal of Hygiene and Environmental Health
JF - International Journal of Hygiene and Environmental Health
IS - 2
ER -