ISGlobal, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain; Fundació Institut Universitari per a La Recerca a L'Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola Del Vallès, Spain.
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Environ Pollut. 2020 Nov;266(Pt 3):115266. doi: 10.1016/j.envpol.2020.115266. Epub 2020 Jul 28.
Urban environments are characterized by multiple exposures that may influence body mass index (BMI) growth in early life. Previous studies are few, with inconsistent results and no evaluation of simultaneous exposures. Thus, this study aimed to assess the associations between exposure to air pollution, green spaces and built environment characteristics, and BMI growth trajectories from 0 to 5 years. This longitudinal study used data from an electronic primary care health record database in Catalonia (Spain), including 79,992 children born between January 01, 2011 and December 31, 2012 in urban areas and followed until 5 years of age. Height and weight were measured frequently during childhood and BMI (kg/m) was calculated. Urban exposures were estimated at census tract level and included: air pollution (nitrogen dioxide (NO), particulate matter <10 μm (PM) and <2.5 μm (PM), green spaces (Normalized Difference Vegetation Index (NDVI) and % green space) and built environment (population density, street connectivity, land use mix, walkability index). Individual BMI trajectories were estimated using linear spline multilevel models with several knot points. In single exposure models, NO PM PM and population density were associated with small increases in BMI growth (e.g. β per IQR PM increase = 0.023 kg/m, 95%CI: 0.013, 0.033), and NDVI, % of green spaces and land use mix with small reductions in BMI growth (e.g. β per IQR % green spaces increase = -0.015 kg/m 95%CI: -0.026, -0.005). These associations were strongest during the first two months of life. In multiple exposure models, most associations were attenuated, with only those for PM and land use mix remaining statistically significant. This large longitudinal study suggests that early life exposure to air pollution, green space and built environment characteristics may be associated with small changes in BMI growth trajectories during the first years of life, and that it is important to account for multiple exposures in urban settings.
城市环境具有多种暴露因素，这些因素可能会影响儿童早期的体重指数（BMI）增长。先前的研究较少，结果不一致，且没有同时评估多种暴露因素。因此，本研究旨在评估 0 至 5 岁期间，空气污染、绿地和建成环境特征暴露与 BMI 增长轨迹之间的关联。这项纵向研究使用了加泰罗尼亚（西班牙）电子初级保健健康记录数据库中的数据，包括 2011 年 1 月 1 日至 2012 年 12 月 31 日期间在城区出生且随访至 5 岁的 79992 名儿童。在儿童期，身高和体重经常被测量，并且计算 BMI（kg/m）。在普查区层面估计了城市暴露因素，包括：空气污染（二氧化氮（NO）、<10μm 颗粒物（PM）和<2.5μm 颗粒物（PM）、绿地（归一化植被差异指数（NDVI）和绿地百分比）和建成环境（人口密度、街道连通性、土地利用混合度、步行指数）。使用带有多个结点位的线性样条多层模型估计个体 BMI 轨迹。在单一暴露模型中，NO、PM 和 PM 以及人口密度与 BMI 增长的小幅度增加相关（例如，每 IQR PM 增加的 β=0.023kg/m，95%CI：0.013，0.033），NDVI、绿地百分比和土地利用混合度与 BMI 增长的小幅度减少相关（例如，每 IQR 绿地百分比增加的 β=-0.015kg/m，95%CI：-0.026，-0.005）。这些关联在生命的头两个月最为强烈。在多暴露模型中，大多数关联减弱，只有 PM 和土地利用混合度的关联仍具有统计学意义。这项大型纵向研究表明，生命早期暴露于空气污染、绿地和建成环境特征可能与生命最初几年的 BMI 增长轨迹的微小变化相关，并且在城市环境中考虑多种暴露因素很重要。
