Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Environ Res. 2021 Jun;197:111162. doi: 10.1016/j.envres.2021.111162. Epub 2021 Apr 24.
Natural vegetation, or greenness, is thought to improve health through its ability to buffer and reduce harmful environmental exposures as well as relieve stress, promote physical activity, restore attention, and increase social cohesion. In concert, these effects could help mitigate the detrimental effects of air pollution on reproductive aging in women.
Our analysis included 565 women attending the Massachusetts General Hospital Fertility Center (2004-2014) who had a measured antral follicle count (AFC), a marker of ovarian reserve. We calculated peak residential greenness in the year prior to AFC using 250 m normalized difference vegetation index (NDVI) from the Terra and Aqua satellites operated by the United States National Aeronautics and Space Administration. Validated spatiotemporal models estimated daily residential exposure to particulate matter <2.5 μm (PM) for the 3 months prior to AFC. Poisson regression models with robust standard errors were used to estimate the association between peak greenness, average PM exposure, and AFC adjusted for age, BMI, smoking status, education, year, and season.
Women in our study had a mean age of 35.2 years with a standard deviation (SD) of 4.3 years (min: 20 years, max: 45 years). The peak residential NDVI ranged from 0.07 to 0.92 with a SD of 0.18. There was no statistically significant association between peak residential greenness and AFC; however, higher exposure to PM was associated with lower AFC (-6.2% per 2 μg/m [1 SD increase] 95% CI -11.8, -0.3). There was a significant interaction between exposure to PM and peak greenness on AFC (P-interaction: 0.03). Among women with an average PM exposure of 7 μg/m, a SD increase in residential peak greenness was associated with a 5.6% (95% CI -0.4, 12.0) higher AFC. Conversely, among women with a PM exposure of 12 μg/m, a SD increase in residential peak greenness was associated with a 5.8% (95% CI -13.1, 2.1) lower AFC.
Residing in an area with high levels of greenness may slow reproductive aging in women only when exposure to PM is low.
人们认为自然植被（绿色植物）可以缓冲和减少有害的环境暴露，缓解压力，促进身体活动，恢复注意力，增加社会凝聚力，从而改善健康。这些影响可能有助于减轻空气污染对女性生殖衰老的不利影响。
我们的分析包括 2004 年至 2014 年期间在马萨诸塞州综合医院生育中心就诊的 565 名女性，她们均接受了卵巢储备功能的检测，即测量卵巢内的窦卵泡数（AFC）。我们使用美国国家航空航天局（NASA）运营的 Terra 和 Aqua 卫星的 250m 归一化差异植被指数（NDVI），计算出 AFC 前一年的住宅峰值绿化值。经过验证的时空模型估计了 AFC 前 3 个月的每日住宅细颗粒物（PM）<2.5μm 的暴露量。使用具有稳健标准差的泊松回归模型，根据年龄、BMI、吸烟状况、教育程度、年份和季节，调整 AFC 后，估计峰值绿化、平均 PM 暴露与 AFC 之间的关联。
我们研究中的女性平均年龄为 35.2 岁，标准差（SD）为 4.3 岁（最小：20 岁，最大：45 岁）。住宅峰值 NDVI 范围为 0.07 至 0.92，SD 为 0.18。住宅峰值绿化与 AFC 之间无统计学意义的关联；然而，PM 暴露较高与 AFC 较低有关（每增加 2μg/m [1 SD 增加]，-6.2% 95%CI-11.8，-0.3）。PM 暴露与峰值绿化对 AFC 的交互作用有显著差异（P 交互作用：0.03）。在平均 PM 暴露为 7μg/m 的女性中，住宅峰值绿化的 SD 增加与 AFC 增加 5.6%（95%CI 0.4，12.0）有关。相反，在 PM 暴露为 12μg/m 的女性中，住宅峰值绿化的 SD 增加与 AFC 降低 5.8%（95%CI-13.1，2.1）有关。
只有当 PM 暴露水平较低时，居住在绿化水平较高的地区可能会减缓女性的生殖衰老。
