{"title":"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。","authors":"Qing Guan, Chunyang Zhu, Guo Zhang, Jian Wang, Hao Xiang, Yujia Chen, Hao Cui","doi":"10.1016/j.envpol.2023.122579","DOIUrl":null,"url":null,"abstract":"<p><p>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<sub>2.5</sub>) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM<sub>2.5,</sub> 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<sub>_1000m</sub> of 1.441 km<sup>2</sup>, RD<sub>_1000m</sub> of 3.856 km/km<sup>2</sup>, and NL<sub>_1000m</sub> of 9.821 nW/cm<sup>2</sup>/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA<sub>_1000m</sub>, RD<sub>_1000m</sub>, and NL<sub>_1000m</sub>, 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<sub>2.5</sub> 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.</p>","PeriodicalId":311,"journal":{"name":"Environmental Pollution","volume":"337 ","pages":"122579"},"PeriodicalIF":7.6000,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults.\",\"authors\":\"Qing Guan, Chunyang Zhu, Guo Zhang, Jian Wang, Hao Xiang, Yujia Chen, Hao Cui\",\"doi\":\"10.1016/j.envpol.2023.122579\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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<sub>2.5</sub>) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM<sub>2.5,</sub> 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<sub>_1000m</sub> of 1.441 km<sup>2</sup>, RD<sub>_1000m</sub> of 3.856 km/km<sup>2</sup>, and NL<sub>_1000m</sub> of 9.821 nW/cm<sup>2</sup>/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA<sub>_1000m</sub>, RD<sub>_1000m</sub>, and NL<sub>_1000m</sub>, 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<sub>2.5</sub> 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.</p>\",\"PeriodicalId\":311,\"journal\":{\"name\":\"Environmental Pollution\",\"volume\":\"337 \",\"pages\":\"122579\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2023-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Environmental Pollution\",\"FirstCategoryId\":\"93\",\"ListUrlMain\":\"https://doi.org/10.1016/j.envpol.2023.122579\",\"RegionNum\":2,\"RegionCategory\":\"环境科学与生态学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ENVIRONMENTAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Environmental Pollution","FirstCategoryId":"93","ListUrlMain":"https://doi.org/10.1016/j.envpol.2023.122579","RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/21 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults.
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 (PM2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM2.5, 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 PM2.5 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.
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.
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