Li Jia-Xin, Li Li, Fan Shujun, Li Beibei, Qiu Hui-Ling, Xu Aimin, Xie Yu-Ting, He Chuanjiang, Zhou Gang-Long, Zhu Xiao-Qi, Wang Lu, Jiang Jian-Cheng, Chen Hui-Yun, He Yan-Zhao, Jiang Qinqin, Zhang Zhou-Bin, Dong Guang-Hui, Hu Qiansheng, Zou Xiaoguang, Yang Bo-Yi
Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
Department of Respiratory and Critical Care Medicine, The First People's Hospital of Kashi (The Affiliated Kashi Hospital of Sun Yat-Sen University), Kashgar City 844000, China.
Environ Health (Wash). 2025 Apr 22;3(7):777-786. doi: 10.1021/envhealth.4c00278. eCollection 2025 Jul 18.
Dyslipidemia is a significant risk factor for cardiovascular disease. While cross-sectional studies suggest lower odds of dyslipidemia in greener environments, longitudinal research is limited. This prospective cohort study analyzed data from 3,454,623 adults from January 2017 to December 2021, focusing on dyslipidemia and its subtypes. Residential greenness was assessed using vegetation indices and greenspace percentages. Cox regressions and generalized estimating equation models were used to analyze associations between greenness and dyslipidemia outcomes. Over a median follow-up period of 3.21 years, 744,732 cases of dyslipidemia were observed. Greener environments were associated with a reduced risk of dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and hyperbetalipoproteinemia (hazard ratios ranged from 0.82 to 0.96) and an increased risk of hypoalphalipoproteinemia (hazard ratios were 1.12 to 1.15). Higher greenness levels were linked to lower serum lipids. These associations were stronger among older adults and those with higher education. Mediation analyses showed that lower air pollution, temperature, and higher physical activity accounted for 2.08-33.72% of the associations between greenness and dyslipidemia. Our findings suggest that greenspace exposure can be incorporated into dyslipidemia etiology and prevention strategies. Nature therapies like forest bathing can be supplementary strategies.
血脂异常是心血管疾病的一个重要危险因素。虽然横断面研究表明在更绿色的环境中血脂异常的几率较低，但纵向研究有限。这项前瞻性队列研究分析了2017年1月至2021年12月期间3454623名成年人的数据，重点关注血脂异常及其亚型。使用植被指数和绿地百分比评估居住环境的绿化程度。采用Cox回归和广义估计方程模型分析绿化程度与血脂异常结果之间的关联。在中位随访期3.21年期间，观察到744732例血脂异常病例。更绿色的环境与血脂异常、高胆固醇血症、高甘油三酯血症和高β脂蛋白血症风险降低相关（风险比范围为0.82至0.96），而与低α脂蛋白血症风险增加相关（风险比为1.12至1.15）。更高的绿化水平与更低的血脂相关。这些关联在老年人和受过高等教育的人群中更强。中介分析表明，较低的空气污染、温度和较高的身体活动占绿化程度与血脂异常之间关联的2.08 - 33.72%。我们的研究结果表明，接触绿地可纳入血脂异常的病因学和预防策略。像森林浴这样的自然疗法可以作为补充策略。
