TY - JOUR
T1 - Living near greenness is associated with higher bone strength
T2 - A large cross-sectional epidemiological study in China
AU - Jiang, Ye
AU - Kang Zhuo, Bai Ma
AU - Guo, Bing
AU - Zeng, Pei Bin
AU - Guo, Yu Ming
AU - Chen, Gong Bo
AU - Wei, Jing
AU - He, Rui Feng
AU - Li, Zhi Feng
AU - Zhang, Xue Hui
AU - Wang, Zi Yun
AU - Li, Xuan
AU - Wang, Lei
AU - Zeng, Chun Mei
AU - Chen, Lin
AU - Xiao, Xiong
AU - Zhao, Xing
AU - on behalf of the China MultiEthnic Cohort (CMEC) collaborative group
N1 - Funding Information:
This work was supported by the Foundation of National Key Research and Development Program of China (Grant number: 2017YFC0907305 ); National Natural Science Foundation of China (Grant number: 81973151 , 81903415 ); China Postdoctoral Science Foundation (Grant number: 2020M683335 ); and the Sichuan Province Application Foudation Project od Office of Science and Technology (Grant number: 2020JDJQ0014 ).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/7/20
Y1 - 2022/7/20
N2 - Background: Living near green spaces may benefit various health outcomes. However, no studies have investigated the greenness-bone linkage in the general population. Moreover, to which extent ambient air pollution (AAP), physical activity (PA), and body mass index (BMI) mediate this relationship remains unclear. We aimed to explore the association between greenness and bone strength and the potential mediating roles of AAP, PA, and BMI in Chinese adults. Methods: This cross-sectional analysis enrolled 66,053 adults from the China Multi-Ethnic Cohort in 2018–2019. The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were employed to define residential greenness. The calcaneus quantitative ultrasound index (QUI) was used to indicate bone strength. Multiple linear regression models and mediation analyses were used to estimate the residential greenness-bone strength association and potential pathways operating through AAP (represented by PM2.5 [particulate matter <2.5 μm in diameter]), PA, and BMI. Stratification analyses were performed to identify susceptible populations. Results: Higher residential exposure to greenness was significantly associated with an increase in QUI, with changes (95% confidence interval) of 3.28 (3.05, 3.50), 3.57 (3.34, 3.80), 2.68 (2.46, 2.90), and 2.93 (2.71, 3.15) for every interquartile range increase in NDVI500m, NDVI1000m, EVI500m, and EVI1000m, respectively. Sex, urbanicity, annual family income, smoking, and drinking significantly modified the association of greenness-bone strength, with more remarkable associations in males, urban residents, subjects from wealthier families, smokers, and drinkers. For the NDVI500m/EVI500m-QUI relationship, the positive mediating roles of PM2.5 and PA were 6.70%/8.50 and 2.43%/2.69%, respectively, whereas those negative for BMI and PA-BMI were 0.88%/1.06% and 0.05%/0.05%, respectively. Conclusion: Living in a greener area may predict higher bone strength, particularly among males, urban residents, wealthier people, smokers, and drinkers. AAP, PA, BMI, and other factors may partially mediate the positive association. Our findings underscore the importance of optimizing greenness planning and management policies.
AB - Background: Living near green spaces may benefit various health outcomes. However, no studies have investigated the greenness-bone linkage in the general population. Moreover, to which extent ambient air pollution (AAP), physical activity (PA), and body mass index (BMI) mediate this relationship remains unclear. We aimed to explore the association between greenness and bone strength and the potential mediating roles of AAP, PA, and BMI in Chinese adults. Methods: This cross-sectional analysis enrolled 66,053 adults from the China Multi-Ethnic Cohort in 2018–2019. The normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were employed to define residential greenness. The calcaneus quantitative ultrasound index (QUI) was used to indicate bone strength. Multiple linear regression models and mediation analyses were used to estimate the residential greenness-bone strength association and potential pathways operating through AAP (represented by PM2.5 [particulate matter <2.5 μm in diameter]), PA, and BMI. Stratification analyses were performed to identify susceptible populations. Results: Higher residential exposure to greenness was significantly associated with an increase in QUI, with changes (95% confidence interval) of 3.28 (3.05, 3.50), 3.57 (3.34, 3.80), 2.68 (2.46, 2.90), and 2.93 (2.71, 3.15) for every interquartile range increase in NDVI500m, NDVI1000m, EVI500m, and EVI1000m, respectively. Sex, urbanicity, annual family income, smoking, and drinking significantly modified the association of greenness-bone strength, with more remarkable associations in males, urban residents, subjects from wealthier families, smokers, and drinkers. For the NDVI500m/EVI500m-QUI relationship, the positive mediating roles of PM2.5 and PA were 6.70%/8.50 and 2.43%/2.69%, respectively, whereas those negative for BMI and PA-BMI were 0.88%/1.06% and 0.05%/0.05%, respectively. Conclusion: Living in a greener area may predict higher bone strength, particularly among males, urban residents, wealthier people, smokers, and drinkers. AAP, PA, BMI, and other factors may partially mediate the positive association. Our findings underscore the importance of optimizing greenness planning and management policies.
KW - Ambient air pollution
KW - Body mass index
KW - Bone health
KW - Green space
KW - Mediation analyses
KW - Physical activity
UR - http://www.scopus.com/inward/record.url?scp=85129733813&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2022.155393
DO - 10.1016/j.scitotenv.2022.155393
M3 - Article
C2 - 35461937
AN - SCOPUS:85129733813
SN - 0048-9697
VL - 831
JO - Science of the Total Environment
JF - Science of the Total Environment
M1 - 155393
ER -
