早期接触绿色空间与胰岛素抵抗：从婴儿期到青春期早期的评估。
Early life exposure to green space and insulin resistance: An assessment from infancy to early adolescence.
机构信息
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
出版信息
Environ Int. 2020 Sep;142:105849. doi: 10.1016/j.envint.2020.105849. Epub 2020 Jun 24.
BACKGROUND
Recent studies suggest that greater exposure to natural vegetation, or "green space" is associated with lower diabetes risk, possibly through increasing physical activity. However, there is limited research on green space and insulin resistance in youth. We hypothesized greater green space at early-life sensitive time periods would be associated with lower insulin resistance in youth.
METHODS
We used data from Project Viva (N = 460), a pre-birth cohort study that recruited pregnant women in eastern Massachusetts, 1999-2002, and followed offspring into adolescence. We defined residential green space exposure at infancy (median age - 1.1 years), early childhood (3.2 years), mid-childhood (7.7 years), and early adolescence (12.8 years), using 30 m resolution Landsat satellite imagery to estimate the Normalized Difference Vegetation Index [NDVI]. Our main outcome was early adolescence estimated insulin resistance (HOMA-IR). We used multiple imputation to account for missing data and multiple linear regression models adjusted for age, sex, race/ethnicity, parental education, household income, and neighborhood median household income.
RESULTS
The highest green space tertile had the highest percentage of white participants (85%), college-educated mothers (87%) and fathers (85%), and households with income higher than US$70,000 (86%). Unadjusted models showed that participants living in the highest green space tertile at infancy had a 0.15 unit lower HOMA-IR (95% CI: -0.23, -0.06) in early adolescence, than those living in the lowest tertile. However, in adjusted models, we did not observe evidence of associations between green space from infancy to early adolescence and HOMA-IR in early adolescence, although some point estimates were in the hypothesized direction. For example, participants in the highest green space tertile in infancy had 0.03 units lower HOMA-IR (95%CI: -0.14, 0.08) than those living in the lowest tertile.
CONCLUSIONS
Exposure to green space at early life sensitive time periods was not associated with HOMA-IR in youth. Early-life longitudinal studies across diverse populations are needed to confirm or refute our results.
背景
最近的研究表明，更多地接触自然植被，即“绿色空间”，与较低的糖尿病风险有关，这可能是通过增加身体活动来实现的。然而，关于绿色空间与青少年胰岛素抵抗的研究有限。我们假设，在生命早期敏感时期，更多的绿色空间与青少年较低的胰岛素抵抗有关。
方法
我们使用了来自 Viva 项目（N=460）的数据，这是一项在马萨诸塞州东部招募孕妇的孕前队列研究，从 1999 年至 2002 年进行随访，直至青少年时期。我们在婴儿期（中位数年龄为 1.1 岁）、幼儿期（3.2 岁）、儿童中期（7.7 岁）和青少年早期（12.8 岁）定义了居住绿地暴露，使用 30 米分辨率的陆地卫星图像来估计归一化植被指数[NDVI]。我们的主要结果是青少年早期估计的胰岛素抵抗[HOMA-IR]。我们使用多重插补来处理缺失数据，并使用多元线性回归模型来调整年龄、性别、种族/民族、父母教育程度、家庭收入和邻里家庭收入中位数。
结果
绿地最高三分位数的参与者中，白人参与者的比例最高（85%），母亲（87%）和父亲（85%）都受过大学教育，家庭收入高于 70000 美元（86%）。未调整模型显示，婴儿期生活在绿地最高三分位数的参与者，其青少年早期的 HOMA-IR 低 0.15 个单位（95%CI：-0.23，-0.06），而生活在最低三分位数的参与者则没有。然而，在调整后的模型中，我们没有观察到从婴儿期到青少年早期的绿地与青少年早期 HOMA-IR 之间存在关联的证据，尽管有些点估计值与假设方向一致。例如，婴儿期生活在绿地最高三分位数的参与者，其 HOMA-IR 比生活在最低三分位数的参与者低 0.03 个单位（95%CI：-0.14，0.08）。
结论
生命早期敏感时期暴露于绿色空间与青少年的 HOMA-IR 无关。需要在不同人群中进行早期生命纵向研究，以证实或反驳我们的结果。
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