Residential greenness and blood lipids in urban-dwelling adults: The 33 Communities Chinese Health Study

Bo-Yi Yang; Iana Markevych; Joachim Heinrich; Michael S Bloom; Zhengmin Qian; Sarah Dee Geiger; Michael Vaughn; Shan Liu; Yuming Guo; Shyamali C Dharmage; Bin Jalaludin; Luke D Knibbs; Da Chen; Pasi Jalava; Shao Lin; Steve Hung-Lam Yim; Kang-Kang Liu; Xiao-Wen Zeng; Li-Wen Hu; Guang-Hui Dong

doi:10.1016/j.envpol.2019.03.128

Residential greenness and blood lipids in urban-dwelling adults: The 33 Communities Chinese Health Study

Environ Pollut. 2019 Jul:250:14-22. doi: 10.1016/j.envpol.2019.03.128. Epub 2019 Apr 4.

Authors

Bo-Yi Yang¹, Iana Markevych², Joachim Heinrich³, Michael S Bloom⁴, Zhengmin Qian⁵, Sarah Dee Geiger⁶, Michael Vaughn⁷, Shan Liu⁸, Yuming Guo⁹, Shyamali C Dharmage¹⁰, Bin Jalaludin¹¹, Luke D Knibbs¹², Da Chen¹³, Pasi Jalava¹⁴, Shao Lin⁴, Steve Hung-Lam Yim¹⁵, Kang-Kang Liu¹, Xiao-Wen Zeng¹, Li-Wen Hu¹, Guang-Hui Dong¹⁶

Affiliations

¹ Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
² Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
³ Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336, Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Ziemssenstraße 1, 80336, Munich, Germany.
⁴ Department of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA.
⁵ Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, 63104, USA.
⁶ School of Nursing and Health Studies, Northern Illinois University, DeKalb, 60115, USA.
⁷ School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, 63103, USA.
⁸ NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment 7 Panjiayuan Nanli, Room 312, Beijing, 100021, China.
⁹ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
¹⁰ Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia; Murdoch Children Research Institute, Melbourne, VIC, 3010 Australia.
¹¹ Centre for Air Quality and Health Research and Evaluation, Glebe, NSW, 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW, 2052, Australia.
¹² School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia.
¹³ School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, 510632, China.
¹⁴ Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, FI 70211, Finland.
¹⁵ Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong, Shatin, N.T, Hong Kong, China; Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China; Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China.
¹⁶ Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address: donggh5@mail.sysu.edu.cn.

PMID: 30981931
DOI: 10.1016/j.envpol.2019.03.128

Abstract

While exposure to places with higher greenness shows health benefits, evidence is scarce on its lipidemic effects. We assessed the associations between residential greenness and blood lipids and effect mediations by air pollution, physical activity, and adiposity in China. Our study included 15,477 adults from the population-based 33 Communities Chinese Health Study, conducted between April and December 2009, in Northeastern China. We measured total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Residential greenness was estimated using two satellite-derived vegetation indices - the Normalized Difference Vegetation Index (NDVI) and the Soil Adjusted Vegetation Index (SAVI). We used both nitrogen dioxide (NO₂) and particles ≤2.5 μm in aerodynamic diameter (PM_2.5) as proxies of outdoor air pollution. Associations were assessed using linear mixed effects regression models and logistic mixed effects regression models, and mediation analyses were also performed. Living in higher greenness areas was consistently associated with lower TC, TG, and LDL-C levels and higher HDL-C levels (e.g., change in TC, TG, LDL-C, and HDL-C per 0.1-unit increase in NDVI_500-m was -1.52%, -3.05%, -1.91%, and 0.52%, respectively). Similar results were obtained for the corresponding dyslipidemias. These associations were generally stronger in women and older adults. While educational levels showed effect modifications, the effect pattern was inconsistent. Both outdoor air pollution and body mass index mediated 9.1-62.3% and 5.6-40.1% of the associations for greenness and blood lipids, respectively, however, physical activity did not. Our results suggest beneficial associations between residing in places with higher greenness and blood lipid levels, especially in women and the elder individuals. The associations were partly mediated by lower air pollution and adiposity.

Keywords: Blood lipids; Cross-sectional study; Dyslipidemia; Greenness; Mediation.

MeSH terms

Adiposity
Aged
Air Pollution / adverse effects
Air Pollution / analysis*
Body Mass Index
Built Environment*
China
Environmental Exposure / adverse effects
Environmental Exposure / analysis*
Female
Humans
Linear Models
Lipids / blood*
Male
Middle Aged
Nitrogen Dioxide / adverse effects
Nitrogen Dioxide / analysis
Obesity / epidemiology
Particulate Matter / adverse effects
Particulate Matter / analysis
Urban Population*

Substances

Lipids
Particulate Matter
Nitrogen Dioxide