1.武汉大学公共卫生学院流行病与卫生统计学系 湖北 武汉 430071
2.三峡大学基础医学院临床医学系 湖北 宜昌 443000
3.咸宁市疾病预防控制中心 湖北 咸宁 437000
刘志文,男,1999—,医学硕士,主要从事环境流行病学研究,E⁃mail:2020283050100@whu.edu.cn
马露,男,1976—,医学博士,副教授,硕士生导师,主要从事环境流行病学研究,E⁃mail:malu@whu.edu.cn
收稿:2024-10-31,
纸质出版:2025-09-26
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刘志文,李培政,黄诗琪等.绿地覆盖与居民糖尿病罹患的关联性研究[J].武汉大学学报(医学版),2025,46(09):1195-1202.
LIU Zhiwen,LI Peizheng,HUANG Shiqi,et al.Association between residential greenness coverage and diabetes mellitus among residents[J].Medical Journal of Wuhan University,2025,46(09):1195-1202.
刘志文,李培政,黄诗琪等.绿地覆盖与居民糖尿病罹患的关联性研究[J].武汉大学学报(医学版),2025,46(09):1195-1202. DOI: 10.14188/j.1671-8852.2024.0831.
LIU Zhiwen,LI Peizheng,HUANG Shiqi,et al.Association between residential greenness coverage and diabetes mellitus among residents[J].Medical Journal of Wuhan University,2025,46(09):1195-1202. DOI: 10.14188/j.1671-8852.2024.0831.
目的
2
评估住宅绿地覆盖与成年居民糖尿病(DM)罹患的关联,并探讨体质量指数(BMI)以及颗粒污染物在其中的潜在调节作用。
方法
2
依托于“国家心血管病高危人群早期筛查与综合干预项目”,调查2015年12月至2018年12月之间在湖北省咸宁市参与心血管疾病高危人群初次筛查的自然人群(≥18岁),采用归一化植被指数(NDVI)评估人群的绿地覆盖水平。采用二分类逻辑回归模型分析绿地与DM的关联性,并构建单变量中介模型评价BMI以及颗粒污染物在其中的中介效应。基于人口社会学特征以及污染物暴露水平分层,进行亚组分析。采用限制性立方样条函数描述剂量效应关系。
结果
2
11 760名研究对象中,DM患者2 624例,患病率为22.31%。NDVI 1 000 m缓冲区(NDVI
1000m
)、1 500 m缓冲区(NDVI
1500m
)以及2 000 m缓冲区(NDVI
2000m
)每增加0.1个单位,DM患病风险分别显著降低13.8%、13.9%以及19.6%,
OR
值分别为0.862(95%
CI
: 0.820~0.907)、0.861(95%
CI
: 0.819~0.904)和0.804(95%
CI
: 0.756~0.854)。绿地与DM的负向关联在已婚、65岁及以上以及男性群体中更为显著。此外,尽管未发现BMI和颗粒污染物在绿地覆盖与DM关联中的显著中介效应,但在低水平颗粒污染物暴露组中绿地与DM的负向关联更加显著。绿地与DM间呈现近似线性剂量效应关系。
结论
2
绿地覆盖可显著降低DM患病风险,并且这种健康益处在已婚、老年人、男性以及低颗粒污染物暴露组群体中更为明显。
Objective
2
To evaluate the association between residential green space coverage and the incidence of diabetes mellitus (DM) in adult residents
and to explore the potential moderating roles of body mass index (BMI) and particulate pollutants.
Methods
2
Based on the "National Cardiovascular Disease High⁃Risk Population Early Screening and Comprehensive Intervention Project"
a survey was conducted on the natural population (aged ≥18 years) who participated in the initial screening for high⁃risk cardiovascular disease between December 2015 and December 2018 in Xianning City
Hubei Province
China. The normalized difference vegetation index (NDVI) was used to assess greenness coverage. A binary logistic regression model was employed to analyze the association between greenness and DM. Subgroup analyses were conducted based on sociodemographic characteristics and pollutant exposure levels. Dose⁃response relationships were evaluated using a restricted cubic spline function.
Results
2
Among the 11 760 participants
there were 2 624 cases of DM
with a prevalence of 22.31%. For each 0.1⁃unit increase in NDVI at 1 000 m
1 500 m
and 2 000 m
the risk of DM significantly decreased by 13.8%
13.9%
and 19.6%
respectively
with
OR
s of 0.862 (95%
CI
: 0.820⁃0.907)
0.861 (95%
CI
: 0.819⁃0.904)
and 0.804 (95%
CI
: 0.756⁃0.854). No significant mediating effects of BMI and particulate pollutants were found in the association between NDVI and DM. The inverse association between greenness coverage and DM was more pronounced among married individuals
those with low particulate pollutant exposure
older adults (≥65 years)
and men. A near⁃linear dose⁃response relationship was observed between greenness coverage and DM.
Conclusion
2
Greenness coverage significantly reduces the risk of DM
moreover
this health benefit demonstrated greater magnitude among married individuals
older adults
males
and those with lower exposure to particulate matter.
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