Global greenness in relation to reducing the burden of cardiovascular diseases: ischemic heart disease and stroke
Global greenness in relation to reducing the burden of cardiovascular diseases: ischemic heart disease and stroke
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DOI：
10.1088/1748-9326/abbbaf
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发表时间：
2020-12-01
影响因子：
6.7
通讯作者：
Spengler, John D.
中科院分区：
文献类型：
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作者：
Asri, Aji Kusumaning;Yu, Chia-Pin;Spengler, John D.
这项生态研究旨在确定全球 183 个国家的绿色与心血管疾病（如缺血性心脏病 (IHD) 和中风）之间的关联。世界卫生组织提供的国家级伤残调整生命年（DALY）数据库用于代表研究国家因缺血性心脏病和中风造成的健康负担。通过评估归一化植被指数（NDVI-MOD13A3）来估计每个国家的绿化程度。考虑潜在的协变量后，应用广义线性混合模型惩罚准似然性和敏感性测试来确定与 IHD 和中风导致的 DALY 损失相关的绿色度。然后进行分层分析，以确定绿色对不同性别、年龄和经济状况水平的影响。研究发现绿色与 IHD 和中风之间始终存在显着的负相关关系；基于 NDVI 从 0 增加到 1 的 DALY 变化，主模型的 NDVI 系数分别为 -11.245 (95% CI: -16.770, -5.720) 和 -4.387 (95% CI:-7.926, -0.085)。分层分析在女性和男性中均发现了这些影响。在不同年龄组中也发现了绿色与 IHD 以及中风之间的负相关性，并且在低收入和中等收入国家中被证实具有显着性。
This ecological study aimed to identify the association between greenness and cardiovascular diseases in terms of ischemic heart disease (IHD) and stroke in 183 countries worldwide. The country-level disability-adjusted life year (DALY) database provided by the WHO was used to represent the health burden due to IHD and stroke for the study countries. Normalized Difference Vegetation Index (NDVI-MOD13A3) was assessed to estimate the greenness in each country. After considering potential covariates, the generalized linear mixed model penalized quasi-likelihood coupled with a sensitivity test was applied to identify the greenness in relation to DALY loss due to IHD and stroke. Stratified analysis was then conducted to determine the effects of greenness among the different levels of gender, age, and economic status. A consistently significant negative association was found between greenness and both IHD and stroke; the NDVI coefficients of the main model were -11.245 (95% CI: -16.770, -5.720) and -4.387 (95% CI:-7.926, -0.085), respectively, in the DALY changes based on the increase of NDVI from 0 to 1. The stratified analysis recognized these effects in both females and males. Negative associations between greenness and IHD as well as stroke were also found in various age groups and were confirmed as significant in low and middle-income countries.