[Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over]

Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Feb 28:57:86-92. doi: 10.3760/cma.j.cn112150-20221117-01118. Online ahead of print.
[Article in Chinese]

Abstract

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

目的: 研究绿地空间暴露与中国老年人腰围(WC)和中心型肥胖的关联。 方法: 数据来源于“中国老年健康影响因素跟踪调查”中2017—2018年的横断面调查数据,将14 056名符合标准的65岁及以上老年人纳入研究。通过问卷调查和体格检查,收集研究对象的人口学特征、生活方式、WC等信息;利用美国国家航空航天局提供的中分辨率成像光谱仪的卫星监测数据,将研究对象1 000 m半径范围内归一化植被指数(NDVI)的年均值作为绿地空间暴露的测量值。采用多因素线性回归模型、多因素logistic回归模型和限制性立方样条(RCS)模型分析NDVI与中国老年人WC及中心型肥胖的关联和剂量反应关系。 结果: 14 056名研究对象的年龄MQ1Q3)为84.0(75.0,94.0)岁;其中男性占45.0%(6 330名);文盲占48.6%(5 853名);农村人口占78.0%(10 964名);WC均值为(84.4±10.8)cm;中心型肥胖占60.2%(8 465名);NDVI范围为(-0.06,0.78)。多因素线性回归模型结果显示,调整相关混杂因素后,NDVI每增加0.1个单位,城市组的WC改变值[β(95%CI)为-0.49(-0.93~-0.06)]小于农村组[-0.78(-0.98~-0.58)](P交互=0.022);与NDVI的Q1组相比,农村人群Q2Q3组WC有所减少,β(95%CI)分别为-1.74(-2.5~-0.98)、-2.78(-3.55~-2.00)。多因素logistic回归模型分析结果显示,调整相关混杂因素后,NDVI每增加0.1个单位,城市和农村人群中心型肥胖的患病风险均降低,OR(95%CI)分别为0.87(0.80~0.95)、0.86(0.82~0.89)(P交互=0.284);与NDVI的Q1组相比,农村人群Q2Q3组中心型肥胖患病风险较低,OR(95%CI)分别为0.68(0.58~0.80)、0.57(0.49~0.68)。RCS拟合模型结果显示,随着NDVI浓度增加,NDVI与WC(P非线性=0.006)及中心型肥胖患病风险(P非线性=0.025)均存在非线性负向关联。 结论: 绿地空间暴露与中国老年人WC及中心型肥胖患病风险均存在负向关联。.

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