Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults.

IF 7.6 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environmental Pollution Pub Date : 2023-11-15 Epub Date: 2023-09-21 DOI:10.1016/j.envpol.2023.122579

Qing Guan, Chunyang Zhu, Guo Zhang, Jian Wang, Hao Xiang, Yujia Chen, Hao Cui

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引用次数: 0

Abstract

The prevalence of type 2 diabetes (T2D) is higher in urban than in rural areas. Limited information is available on the association between T2D and Land urbanization (LU) while LU influences not only greenness and Particulate Matter 2.5 (PM_2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM_2.5, or conscious physical activity mediated any of the observed associations. This study encompassed 27,633 adult participants from Shandong Province who completed the sixth National Health Service Survey in 2018. Ambient LU exposure was estimated by spatial characteristics, including the existing impervious surface area (ISA), road density (RD), and annual night light (NL). Exposures were estimated using satellite images and OpenStreetMap, with 1000 m used as the main analysis buffer. Two-level logistic regression models were used to investigate the association between the LU metrics and T2D. Additionally, we explored potential mechanisms of the association through mediation analysis. The prevalence of T2D among participants was 5.14%, with average exposures to ISA_{_1000m} of 1.441 km², RD_{_1000m} of 3.856 km/km², and NL_{_1000m} of 9.821 nW/cm²/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA_{_1000m}, RD_{_1000m}, and NL_{_1000m}, the adjusted OR (95% CI) for the T2D prevalence were 1.29 (1.19-1.4), 1.25 (1.15-1.36), and 1.25 (1.15-1.36), respectively]. This relationship persisted in several sensitivity analyses including use of different buffer sizes. We observed stronger associations among participants younger than 65 years or in men. Greenness mediated a 20.78%-65.36% of the estimated associations, conscious physical activity mediated a 10.35%-15.85%, while PM_2.5 mediated insignificantly. These results suggest a deleterious association between higher levels of LU and T2D among adult residents in a developing country. Greenness and conscious physical activity mediate the association.

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土地城市化与中国成年人2型糖尿病患病率的关系及绿色和体育活动的中介作用。

城市地区2型糖尿病（T2D）的患病率高于农村地区。关于T2D与土地城市化（LU）之间关系的信息有限，而LU不仅影响绿色度和PM2.5，还影响居民行为。我们旨在探索LU水平与T2D患病率之间的关系，以及绿色、PM2.5或有意识的体育活动是否介导了任何观察到的关联。这项研究涵盖了来自山东省的27633名成年参与者，他们在2018年完成了第六次全国卫生服务调查。环境LU暴露量通过空间特征进行估计，包括现有的不透水表面积（ISA）、道路密度（RD）和年度夜光（NL）。使用卫星图像和OpenStreetMap估计曝光量，1000米作为主要分析缓冲区。使用两级逻辑回归模型来研究LU指标与T2D之间的相关性。此外，我们还通过中介分析探讨了关联的潜在机制。参与者中T2D的患病率为5.14%，ISA_1000m的平均暴露量为1.441 km2，RD_1000m为3.856 km/km2，较高水平的LU暴露与较高的T2D OR相关[对于ISA_1000m、RD_1000m和NL_1000m的每个四分位间距，T2D患病率的校正OR（95%CI）分别为1.29（1.19-1.4）、1.25（1.15-1.36）和1.25（1.15-2.36）]。这种关系在几次敏感性分析中持续存在，包括使用不同的缓冲区大小。我们观察到，在65岁以下的参与者或男性中，这种联系更强。绿色介导了20.78%-65.36%的估计关联，有意识的身体活动介导了10.35%-15.85%，而PM2.5介导不显著。这些结果表明，发展中国家成年居民中较高水平的LU和T2D之间存在有害联系。绿色和有意识的身体活动介导了这种联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environmental Pollution 环境科学-环境科学

CiteScore

16.00

自引率

6.70%

发文量

2082

审稿时长

2.9 months

期刊介绍： Environmental Pollution is an international peer-reviewed journal that publishes high-quality research papers and review articles covering all aspects of environmental pollution and its impacts on ecosystems and human health. Subject areas include, but are not limited to: • Sources and occurrences of pollutants that are clearly defined and measured in environmental compartments, food and food-related items, and human bodies; • Interlinks between contaminant exposure and biological, ecological, and human health effects, including those of climate change; • Contaminants of emerging concerns (including but not limited to antibiotic resistant microorganisms or genes, microplastics/nanoplastics, electronic wastes, light, and noise) and/or their biological, ecological, or human health effects; • Laboratory and field studies on the remediation/mitigation of environmental pollution via new techniques and with clear links to biological, ecological, or human health effects; • Modeling of pollution processes, patterns, or trends that is of clear environmental and/or human health interest; • New techniques that measure and examine environmental occurrences, transport, behavior, and effects of pollutants within the environment or the laboratory, provided that they can be clearly used to address problems within regional or global environmental compartments.