Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Epidemiology and Biostatistics at School Public Health and the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Sci Total Environ. 2022 Mar 10;811:152372. doi: 10.1016/j.scitotenv.2021.152372. Epub 2021 Dec 14.
Growing evidence has linked residential greenness to depression, the results from prospective cohort study are still limited. And it remains unclear whether particulate matter (PM) modify, mediate, or interact the greenness-depression relationship.
We collected data from Yinzhou Cohort(N = 47,516) which was recruited between June 2015 and December 2017. Depression cases before April 2020 were ascertained from local Health Information System covered all residents' health care records. Residential greenness (the Normalized Difference Vegetation Index, NDVI, and the Enhanced Vegetation Index, EVI) and PM (particulate matters with diameters≤2.5 μm, PM and particulate matters with diameters≤10 μm, PM) were estimated based on participants' residential coordinates. We conducted Cox models employing age as timescale to estimate the association between residential greenness within different buffers and incident depression. Furthermore, we explored the potential confounding, mediation and interaction relationship between greenness and PM.
During the 99,556 person-years of follow-up, 1043 incident depression cases occurred. In single exposure models, residential greenness was inversely associated with depression incidence (e.g. Hazard Ratio (HR) = 0.86, 95% confidence interval (CI): 0.79, 0.94 for per interquartile range (IQR) increase NDVI 250 m). The protective association between greenness was attenuated after introducing PM and PM into the models. We identified multiplicative interactions between greenness and PM exposure for depression (e.g. HR = 0.91, 95%CI: 0.85, 0.98 for per IQR decrease NDVI 250 m and per IQR increase PM). Besides, we found the protective association of greenness was partly mediated by PM (e.g. mediation proportion = 52.9% between NDVI 250 m and PM).
In this longitudinal cohort study, residents living in greener neighborhoods had a lower risk of depression incidence and the benefits were interacted and partly mediated by PM. Improvement in residential greenness could be an actionable and planning intervention to prevent depression.
越来越多的证据表明，居住绿化与抑郁有关，但前瞻性队列研究的结果仍然有限。目前尚不清楚颗粒物（PM）是否会改变、调节或相互作用于绿化与抑郁之间的关系。
我们从 2015 年 6 月至 2017 年 12 月期间招募的鄞州区队列（N=47516）中收集数据。2020 年 4 月前从当地健康信息系统中确定抑郁病例，该系统涵盖了所有居民的医疗记录。根据参与者的居住坐标，估算居住绿化（归一化植被指数 NDVI 和增强植被指数 EVI）和 PM（直径≤2.5μm 的颗粒物 PM 和直径≤10μm 的颗粒物 PM）。我们采用年龄为时间刻度的 Cox 模型来估计不同缓冲区的居住绿化与新发抑郁之间的关联。此外，我们还探讨了绿化与 PM 之间的潜在混杂、中介和交互关系。
在 99556 人年的随访期间，发生了 1043 例新发抑郁病例。在单暴露模型中，居住绿化与抑郁发生率呈负相关（例如，每增加一个四分位距（IQR）的 NDVI 250m，HR=0.86，95%置信区间（CI）：0.79，0.94）。在将 PM 和 PM 纳入模型后，绿化与抑郁之间的保护关联减弱。我们发现绿化与 PM 暴露之间存在抑郁的乘法交互作用（例如，每减少一个四分位距（IQR）的 NDVI 250m 和增加一个 IQR 的 PM，HR=0.91，95%CI：0.85，0.98）。此外，我们发现绿化的保护作用部分是由 PM 介导的（例如，NDVI 250m 与 PM 之间的中介比例为 52.9%）。
在这项纵向队列研究中，居住在绿化较好的社区的居民新发抑郁的风险较低，而这种益处与 PM 相互作用并部分由 PM 介导。改善居住绿化可能是预防抑郁的一种可行的干预措施。
