中老年人群的邻里特征与心血管生物标志物：巴尔的摩记忆研究。
Neighborhood Characteristics and Cardiovascular Biomarkers in Middle-Aged and Older Adults: the Baltimore Memory Study.
机构信息
Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
出版信息
J Urban Health. 2021 Feb;98(1):130-142. doi: 10.1007/s11524-020-00499-7.
Neighborhood greenness has been linked to better cardiovascular health, but little is known about its association with biomarkers related to cardiovascular risk. Adverse neighborhood conditions, such as disorder and socioeconomic disadvantage, are associated with higher cardiovascular biomarker levels, but these relationships may differ in neighborhoods with more greenness. This study evaluated cross-sectional associations of validated measures of neighborhood greenness, disorder, and socioeconomic disadvantage with cardiovascular biomarkers in middle-aged and older adults living in Baltimore City. The sample included 500 adults, aged 57-79 years, enrolled in the Baltimore Memory Study and living in Baltimore City during 2009-2010. Multi-level log-gamma regressions examined associations between the three neighborhood characteristics and seven cardiovascular biomarkers. Models additionally evaluated the effect modification by neighborhood greenness on associations of neighborhood disorder and socioeconomic disadvantage with the biomarkers. Adjusting for covariates and neighborhood greenness, greater neighborhood disorder was associated with higher C-reactive protein (exp β = 1.21, SE = 0.11, p = 0.035) and serum amyloid A (exp β = 1.28, SE = 0.12, p = 0.008), while greater neighborhood socioeconomic disadvantage was associated with higher tumor necrosis factor alpha (exp β = 1.24, SE = 0.12, p = 0.019). Higher neighborhood greenness was associated with lower soluble vascular cell adhesion molecule-1, accounting for disorder (exp β = 0.70, SE = 0.10, p = 0.010) and socioeconomic disadvantage (exp β = 0.73, SE = 0.10, p = 0.025). There was no evidence of effect modification among neighborhood characteristics. The findings suggest that neighborhood effects on cardiovascular health may be mediated through cardiovascular biomarker levels, and that socioeconomic disadvantage, disorder, and greenness may each be important features of neighborhoods.
社区绿化与心血管健康呈正相关，但关于其与心血管风险相关生物标志物的关联却知之甚少。不良的社区环境，如混乱和社会经济劣势，与心血管生物标志物水平升高有关，但这些关系在绿化程度较高的社区可能有所不同。本研究评估了经证实的社区绿化、混乱和社会经济劣势与居住在巴尔的摩市的中年和老年人的心血管生物标志物之间的横断面关联。该样本包括 500 名年龄在 57-79 岁之间的成年人，他们参加了巴尔的摩记忆研究，并于 2009-2010 年居住在巴尔的摩市。多层次对数伽马回归分析了三种社区特征与七种心血管生物标志物之间的关系。模型还评估了社区绿化对社区混乱和社会经济劣势与生物标志物之间关联的效应修饰作用。在调整了协变量和社区绿化后，更大的社区混乱与更高的 C 反应蛋白（β = 1.21，SE = 0.11，p = 0.035）和血清淀粉样蛋白 A（β = 1.28，SE = 0.12，p = 0.008）相关，而更大的社区社会经济劣势与更高的肿瘤坏死因子-α（β = 1.24，SE = 0.12，p = 0.019）相关。更高的社区绿化与可溶性血管细胞黏附分子-1 降低相关，考虑到混乱（β = 0.70，SE = 0.10，p = 0.010）和社会经济劣势（β = 0.73，SE = 0.10，p = 0.025）。社区特征之间没有证据表明存在效应修饰。研究结果表明，社区对心血管健康的影响可能通过心血管生物标志物水平来介导，社会经济劣势、混乱和绿化可能都是社区的重要特征。
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