Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
Universitat Pompeu Fabra, Barcelona, Spain.
Environ Health Perspect. 2020 Apr;128(4):47003. doi: 10.1289/EHP5445. Epub 2020 Apr 3.
Land-use changes in city fringes due to urbanization can lead to a reduction of greenspace that may reduce its associated health benefits.
We evaluated the association between changes in residential surrounding built-up land use and cardiometabolic risk factors in an urbanizing peri-urban area of south India and explored the mediating roles of air pollution, physical activity, and stress in these associations.
We analyzed data on 6,039 adults from the third follow-up of the Andhra Pradesh Children and Parent Study (APCAPS) cohort (2010-2012). We generated trajectories of change in residential surrounding built-up land use (buffer areas) from 1995-2009 (stable, slow increase, fast increase) using remote sensing data and image classification methods. We estimated associations between built-up land use trajectories and natural log-transformed blood pressure, waist circumference, triglycerides, fasting glucose, and non-high-density lipoprotein (non-HDL) cholesterol using linear mixed models. We accounted for multiple mediators and the multilevel structure of the data in mediation analyses.
We observed positive associations between a fast increase in built-up land use within of the home and all cardiometabolic risk factors. Compared with participants with stable trajectories, those with the largest increase in built-up land use had 1.5% (95% CI: 0.1, 2.9) higher systolic blood pressure, 2.4% (95% CI: 0.6, 4.3) higher diastolic blood pressure, 2.1% (95% CI: 0.5, 3.8) higher waist circumference, and 1.6% (95% CI: , 3.8) higher fasting glucose in fully adjusted models. Associations were positive, but not statistically significant, for triglycerides, fasting glucose, and non-HDL cholesterol. Physical activity and ambient particulate matter in aerodynamic diameter () partially mediated the estimated associations. Associations between fast build-up and all cardiometabolic risk factors except non-HDL cholesterol were stronger in women than men.
Increases in built-up land use surrounding residences were consistently associated with higher levels of cardiometabolic risk factors. Our findings support the need for better integration of health considerations in urban planning in rapidly urbanizing settings. https://doi.org/10.1289/EHP5445.
城市化导致城市边缘土地利用的变化可能导致绿地减少，从而减少其相关的健康益处。
我们评估了印度南部一个城市化城郊地区住宅周围建成土地利用变化与心血管代谢风险因素之间的关系，并探讨了空气污染、身体活动和压力在这些关联中的中介作用。
我们分析了安得拉邦儿童和父母研究（APCAPS）队列的第三次随访（2010-2012 年）中 6039 名成年人的数据。我们使用遥感数据和图像分类方法，生成了 1995-2009 年住宅周围建成土地利用（缓冲区）变化的轨迹（稳定、缓慢增加、快速增加）。我们使用线性混合模型估计了建成土地利用轨迹与自然对数转换后的血压、腰围、甘油三酯、空腹血糖和非高密度脂蛋白（非 HDL）胆固醇之间的关系。我们在中介分析中考虑了多个中介因素和数据的多层次结构。
我们观察到，住宅周围建成土地利用快速增加与所有心血管代谢风险因素呈正相关。与稳定轨迹的参与者相比，建成土地利用增加最大的参与者收缩压升高 1.5%（95%置信区间：0.1，2.9），舒张压升高 2.4%（95%置信区间：0.6，4.3），腰围增加 2.1%（95%置信区间：0.5，3.8），空腹血糖升高 1.6%（95%置信区间：0.7，3.8），在完全调整的模型中。甘油三酯、空腹血糖和非 HDL 胆固醇的关联呈正相关，但无统计学意义。身体活动和空气动力学直径的环境颗粒物部分介导了估计的关联。快速建成与所有心血管代谢风险因素（非 HDL 胆固醇除外）的关联在女性中强于男性。
住宅周围建成土地利用的增加与心血管代谢风险因素水平的升高呈一致相关。我们的研究结果支持在快速城市化地区将健康考虑因素更好地纳入城市规划的必要性。https://doi.org/10.1289/EHP5445.
