Hu Li-Xin, Fan Shujun, Ma Yinghua, Liu Xiao-Xuan, Bao Wen-Wen, Guo Yuming, Hu Li-Wen, Chen Gongbo, Zeng Xiao-Wen, Zou Zhiyong, Yang Bo-Yi, Ma Jun, Yang Zhicong, Chen Ya-Jun, Dong Guang-Hui
Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
Environ Pollut. 2023 Jan 15;317:120746. doi: 10.1016/j.envpol.2022.120746. Epub 2022 Nov 26.
Little evidence exists concerning the associations of greenspace with childhood lipid profiles and dyslipidemias, especially in developing countries and regions. We aimed to investigate the associations of greenspace surrounding schools with lipid levels and dyslipidemia prevalence among Chinese children and teenagers. We obtained baseline information and health data of 10,408 children and teenagers (aged 6-18 years) who studied from 94 schools in China. We measured levels of four blood lipids: triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Dyslipidemias were defined using standard recommendations. Greenness surrounding schools were assessed using two satellite-based greenness indices, Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) at 300-, 500-, and 1000-m circular buffers based on each school's latitude and longitude. We used random forest model combined with meteorological and remote sensing data to estimate air pollution levels surrounding each school. We used generalized linear mixed models to estimate the associations of greenness with lipid levels and dyslipidemias prevalence. We also performed sub-group and mediation analyses. An interquartile range (IQR) increase in NDVI was significantly associated with a 0.064 mmol/L (95% confidence interval [CI]: 0.083, -0.045) and 0.049 mmol/L (95% CI: 0.065, -0.033) decreased TC and LDL-C levels, respectively, as well as a 0.13-fold (95% CI: 0.01, 0.23) and 0.17-fold (95% CI: 0.01, 0.30) decreased odds of hypercholesterolemia and hyperbetalipoproteinemia, respectively. Associations were stronger in students aged ≤12 years and born to parents having lower education levels compared to their counterparts. Particle with aerodynamic diameter ≤2.5 μm (PM) mediated 61.5% and 16.7% of the association of greenness with TG and LDL-C levels, respectively. In summary, higher school-based greenness exposure was beneficially associated with lipid levels among Chinese children and adolescents, and part of the association can be explained by lowed PM levels.
关于绿地与儿童血脂水平及血脂异常之间的关联，现有证据较少，尤其是在发展中国家和地区。我们旨在调查中国儿童和青少年所在学校周边绿地与血脂水平及血脂异常患病率之间的关联。我们获取了在中国94所学校就读的10408名儿童和青少年（6至18岁）的基线信息和健康数据。我们测量了四种血脂水平：甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）。血脂异常根据标准建议进行定义。基于每所学校的纬度和经度，使用归一化植被指数（NDVI）和土壤调整植被指数（SAVI）这两种基于卫星的绿化指数，在300米、500米和1000米的圆形缓冲区内评估学校周边的绿化情况。我们使用随机森林模型结合气象和遥感数据来估计每所学校周边的空气污染水平。我们使用广义线性混合模型来估计绿化与血脂水平及血脂异常患病率之间的关联。我们还进行了亚组分析和中介分析。NDVI每增加一个四分位数间距（IQR），分别与TC水平降低0.064毫摩尔/升（95%置信区间[CI]：0.083，-0.045）和LDL-C水平降低0.049毫摩尔/升（95%CI：0.065，-0.033）显著相关，以及分别与高胆固醇血症和高β脂蛋白血症的患病几率降低0.13倍（95%CI：0.01，0.23）和0.17倍（95%CI：0.01，0.30）显著相关。与同龄人相比，绿化与血脂水平及血脂异常患病率之间的关联在年龄≤12岁且父母教育水平较低的学生中更强。空气动力学直径≤2.5微米的颗粒物（PM）分别介导了绿化与TG和LDL-C水平之间关联的61.5%和16.7%。总之，在中国儿童和青少年中，较高的学校周边绿化暴露与血脂水平呈有益关联，且部分关联可由较低的PM水平来解释。
