Residential neighbourhood greenspace is associated with reduced risk of incident diabetes in older people: a prospective cohort study.
Residential neighbourhood greenspace is associated with reduced risk of incident diabetes in older people: a prospective cohort study.
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DOI：
10.1186/s12889-016-3833-z
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发表时间：
2016-11-18
影响因子：
4.5
通讯作者：
Wareham NJ
中科院分区：
文献类型：
--
作者：
Dalton AM;Jones AP;Sharp SJ;Cooper AJ;Griffin S;Wareham NJ
三项横断面研究表明，邻里绿地可以预防糖尿病。这项研究使用了一项大样本量的纵向研究的数据，以调查绿色空间与糖尿病发病率之间的关系。数据来自欧洲癌症前瞻性研究，英国诺福克，队列，招募1993-2007年（N = 23，865）。根据参与者的家庭邮政编码（邮政编码），社区被定义为围绕参与者家庭位置的800米圆形缓冲区。根据英国土地覆盖图，绿地暴露被定义为林地、草地、耕地、山地、石南和沼泽占住宅区的百分比。考克斯比例风险回归分析了邻里绿地暴露与糖尿病发病率之间的关系。人群归因分数评估糖尿病病例归因于暴露于最少绿色社区的比例。中介分析评估了身体活动是否解释了绿地和糖尿病之间的关联。交互作用分析被用来测试的修改效果的农村和社会经济地位的绿地和糖尿病之间的关系。模型根据已知和假设的混杂因素进行调整。基线时参与者的平均年龄为59岁，55.1%为女性。平均随访时间为11.3年。居住在最绿色的社区四分位数的个体患糖尿病的相对风险降低19%（HR 0.81; 95% CI 0.67，0.99; p = 0.035;线性趋势p = 0.010）。在调整年龄、性别、BMI、父母是否被诊断患有糖尿病以及个人和社区水平的社会经济状况后，风险比保持相似（HR 0.81; 95% CI 0.65，0.99; p = 0.042）。在完全校正的模型中，HR为0.97归因于通过体力活动的途径，尽管这不显著（95% CI 0.88，1.08; p = 0.603）。在绿色最少的社区（平均有20%的绿色空间），如果他们的绿色程度与整个队列中观察到的平均社区（平均有59%的绿色空间）一样，糖尿病的发病率将下降10.7%（95% CI-2.1%，25.2%; p = 0.106）。乡村性或社会经济地位与绿地水平之间没有显着的相互作用。更绿色的家庭社区可以防止老年人患糖尿病的风险，尽管这项研究不支持体力活动的中介作用。相关的因果机制需要进一步调查。本文的在线版本（doi：10.1186/s12889-016-3833-z）包含补充材料，可供授权用户使用。
Three cross sectional studies suggest that neighbourhood greenspace may protect against incident diabetes. This study uses data from a longitudinal study with a large sample size to investigate the association between greenspace and the occurrence of incident diabetes over time. Data was from the European Prospective Investigation of Cancer Norfolk, UK, cohort, recruitment 1993–2007 (N = 23,865). Neighbourhoods were defined as 800 m circular buffers around participants’ home locations, according to their home postcode (zip code). Greenspace exposure was defined as the percentage of the home neighbourhood that was woodland, grassland, arable land, mountain, heath and bog, according to the UK Land Cover Map. Cox proportional hazards regression examined the association between neighbourhood greenspace exposure and incident diabetes. The population attributable fraction assessed the proportion of diabetes cases attributable to exposure to least green neighbourhoods. Mediation analysis assessed if physical activity explained associations between greenspace and diabetes. Interaction analysis was used to test for the modifying effect of rurality and socio-economic status on the relationship between greenspace and diabetes. Models were adjusted for known and hypothesised confounders. The mean age of participants was 59 years at baseline and 55.1% were female. The mean follow-up time was 11.3 years. Individuals living in the greenest neighbourhood quartile had a 19% lower relative hazard of developing diabetes (HR 0.81; 95% CI 0.67, 0.99; p = 0.035; linear trend p = 0.010). The hazard ratio remained similar (HR 0.81; 95% CI 0.65, 0.99; p = 0.042) after adjusting for age, sex, BMI, whether a parent had been diagnosed with diabetes and socio-economic status at the individual and neighbourhood level. A HR of 0.97 was attributed to the pathway through physical activity in a fully adjusted model, although this was non-significant (95% CI 0.88, 1.08; p = 0.603). The incidence of diabetes in the least green neighbourhoods (with 20% greenspace on average) would fall by 10.7% (95% CI −2.1%, 25.2%; p = 0.106) if they were as green as the average neighbourhood observed across the whole cohort (59% greenspace on average). There were no significant interactions between rurality or socio-economic status and level of greenspace. Greener home neighbourhoods may protect against risk of diabetes in older adults, although this study does not support a mediation role for physical activity. Causal mechanisms underlying the associations require further investigation. The online version of this article (doi:10.1186/s12889-016-3833-z) contains supplementary material, which is available to authorized users.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
5.1
作者：
Guariguata, L.;Whiting, D. R.;Shaw, J. E.
通讯作者：
Shaw, J. E.
影响因子：
8.9
作者：
Lachowycz, K.;Jones, A. P.
通讯作者：
Jones, A. P.
DOI：
10.1186/1479-5868-11-2
发表时间：
2014-01-15
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
Aguiar EJ;Morgan PJ;Collins CE;Plotnikoff RC;Callister R
通讯作者：
Callister R
DOI：
10.3945/ajcn.114.100065
发表时间：
2015-03
期刊：
The American journal of clinical nutrition
影响因子：
--
作者：
Ekelund U;Ward HA;Norat T;Luan J;May AM;Weiderpass E;Sharp SJ;Overvad K;Østergaard JN;Tjønneland A;Johnsen NF;Mesrine S;Fournier A;Fagherazzi G;Trichopoulou A;Lagiou P;Trichopoulos D;Li K;Kaaks R;Ferrari P;Licaj I;Jenab M;Bergmann M;Boeing H;Palli D;Sieri S;Panico S;Tumino R;Vineis P;Peeters PH;Monnikhof E;Bueno-de-Mesquita HB;Quirós JR;Agudo A;Sánchez MJ;Huerta JM;Ardanaz E;Arriola L;Hedblad B;Wirfält E;Sund M;Johansson M;Key TJ;Travis RC;Khaw KT;Brage S;Wareham NJ;Riboli E
通讯作者：
Riboli E