Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
Ecotoxicol Environ Saf. 2023 Oct 1;264:115436. doi: 10.1016/j.ecoenv.2023.115436. Epub 2023 Sep 4.
This study aimed to investigate the relationship of residential green and blue spaces with incident nonalcoholic fatty liver disease (NAFLD), and explore the potential mediation effects of air pollutants and modification effect of genetic susceptibility.
411,200 UK Biobank participants without prior liver diseases were included. Land use data were used to estimate residential green and blue spaces (land coverage percentage) at 300 m and 1000 m buffer. The study outcome was incident NAFLD, ascertained through linkage to hospital admissions and death registry records.
5198 NAFLD cases were documented after a median follow-up of 12.5 years. Green and blue spaces were inversely associated with the hazard of NAFLD: per standard deviation (SD) increment of green space coverage at 300 m (SD: 14.5 %; HR, 0.88, 95 %CI, 0.86-0.91) and 1000 m (SD: 14.1 %; HR, 0.88, 95 %CI, 0.86-0.91) buffer, and blue space coverage at 300 m (SD: 1.0 %; HR,0.95, 95 %CI, 0.93-0.98) and 1000 m (SD: 1.2 %; HR,0.96, 95 %CI, 0.93-0.99) buffer were related with a 4-12 % reduction of NAFLD incidence. The beneficial effects of approximately 25-52 % of green space exposure and about 5-35 % of blue space exposure on NAFLD incidence were mediated by the reduction of PM, NO and NO (All P <0.05). Moreover, genetic susceptibility of NAFLD did not modify the relationship of green and blue spaces with NAFLD incidence.
Residential green and blue spaces were inversely related to NAFLD incidence. These results suggest that green and blue spaces are modifiable factors that may help prevent NAFLD, and therefore, can be considered as a novel environmental strategy to promote liver health at the community level, rather than only at the individual level.
本研究旨在探讨居住绿地和蓝地与非酒精性脂肪性肝病（NAFLD）发病的关系，并探讨空气污染物的潜在中介作用和遗传易感性的修饰作用。
纳入了 411200 名无既往肝脏疾病的英国生物库参与者。利用土地利用数据估计 300m 和 1000m 缓冲区的居住绿地和蓝地（土地覆盖率百分比）。研究结果是通过与医院入院和死亡登记记录的关联确定的新发 NAFLD。
中位随访 12.5 年后，共记录到 5198 例 NAFLD 病例。绿地和蓝地与 NAFLD 的发病风险呈负相关：300m 缓冲区每增加一个标准差（SD）的绿地覆盖率（SD：14.5%；HR，0.88，95%CI，0.86-0.91）和 1000m 缓冲区（SD：14.1%；HR，0.88，95%CI，0.86-0.91），以及 300m 缓冲区每增加一个 SD 的蓝地覆盖率（SD：1.0%；HR，0.95，95%CI，0.93-0.98）和 1000m 缓冲区（SD：1.2%；HR，0.96，95%CI，0.93-0.99）与 NAFLD 发病率降低 4-12%相关。大约 25-52%的绿地暴露和大约 5-35%的蓝地暴露对 NAFLD 发病的有益影响是通过降低 PM、NO 和 NO 来介导的（均 P<0.05）。此外，NAFLD 的遗传易感性不能修饰绿地和蓝地与 NAFLD 发病率之间的关系。
居住绿地和蓝地与 NAFLD 发病率呈负相关。这些结果表明，绿地和蓝地是可改变的因素，可能有助于预防 NAFLD，因此，可以被视为一种新的环境策略，以促进社区一级的肝脏健康，而不仅仅是在个体一级。
