新疆农村居民住宅绿地暴露与心血管疾病发病关系前瞻性队列研究  

Association of exposure to residential green space and cardiovascular disease incidence among rural adult residents in Xinjiang:a prospective cohort study

作　　者：简乐瑶 马儒林[1,2] 郭淑霞 何佳[1,2] 李毓 丁玉松[1,2] 芮东升 毛羿丹 何欣[1] 孙雪莹 廖晟宇[1] 郭恒 JIAN Leyao;MA Rulin;GUO Shuxia;HE Jia;LI Yu;DING Yusong;RUI Dongsheng;MAO Yidan;HE Xin;SUN Xueying;LIAO Shengyu;GUO Heng(Department of Public Health,School of Medicine,Shihezi University,Shihezi 832000,China;National Health Commission Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases/First Afiliated Hospital,School of Medicine,Shihezi University,Shihezi 832000,China)

机构地区：[1]石河子大学医学院预防医学系,石河子832000 [2]国家卫生健康委中亚高发病防治重点实验室,石河子832000

出　　处：《中国公共卫生》2023年第8期996-1000,共5页Chinese Journal of Public Health

基　　金：重点领域科技攻关计划(2021AB030);中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-PT330-003);石河子大学创新发展项目(CXFZ202005)。

摘　　要：目的了解新疆农村居民住宅绿地暴露与心血管疾病(CVD)发病的关系,为该人群的CVD一级预防提供理论基础与数据支持。方法采用前瞻性队列研究方法,于2016年9月采用典型抽样的方法在新疆生产建设兵团第三师51团招募12813名≥18岁农村常住居民进行基线调查,并分别于2019年4月、2020年6月、2021年7月和2022年6月对9659名住址信息完整且基线调查无CVD的居民进行了4次随访调查;采用广义线性混合模型(GLMM)和Cox比例风险回归模型分析新疆农村居民住宅绿地暴露与CVD发病的关系,并采用亚组分析方法分析各分层因素对绿地暴露与CVD发病风险关联的潜在影响。结果截至2022年6月,9659名新疆农村居民中失访655人,失访率为6.78%。最终纳入分析的9004名新疆农村居民共随访49565.76人年,平均随访(5.50±1.09)人年,随访期间CVD发病762例,发病密度为153.73/万人年,CVD累积发病率为8.46%。发生CVD组新疆农村居民的NDVI_(250 m)、NDVI_(500 m)和NDVI_(1000 m)平均值分别为(0.229±0.068)、(0.265±0.067)和(0.298±0.060),均低于未发生CVD组新疆农村居民NDVI_(250 m)、NDVI_(500 m)和NDVI_(1000 m)平均值的(0.242±0.063)、(0.278±0.060)和(0.308±0.053),差异均有统计学意义(均P<0.001)。在调整了性别、年龄、文化程度、婚姻状况、体力活动水平和PM_(2.5)等混杂因素后,GLMM模型分析结果显示,新疆农村居民NDVI_(250 m)、NDVI_(500 m)和NDVI_(1000 m)每增加1个四分位数间距的β值分别为–0.200、–0.169和–0.200;Cox比例风险回归模型分析结果显示,NDVI_(250 m)、NDVI_(500 m)和NDVI_(1000 m)每增加1个四分位数间距,新疆农村居民的CVD发病风险可降低14.4%(HR=0.856,95%CI=0.798~0.919)、14.3%(HR=0.857,95%CI=0.800~0.918)和16.7%(HR=0.833,95%CI=0.755~0.896)。在调整了性别、年龄、文化程度、婚姻状况、体力活动水平、PM_(2.5)中除分层因素外的其他混杂因素后,亚组分析结果显示,住宅绿地�Objective To examine the relationship between exposure to residential green space and the incidence of cardiovascular disease(CVD)among rural residents in Xinjiang Production and Construction Corps(Xinjiang).Methods Totally 12813 rural residents aged≥18 years and living in local regions at least one year were recruited with typical sampling in Xinjiang for a face-to-face baseline questionnaire survey during September 2016 and 9659 of them without CVD and with complete residence information at the baseline survey were followed up four times in April 2019,June 2020,July 2021,and June 2022.Generalized linear model(GLMM)and Cox proportional hazards regression model were used to analyze the relationship between exposure to residential green space(measured with normalized difference vegetation index[NDVI]for the region between a participant's residential location and the center of the residential area and CVD incidence among the participants.Subgroup analysis was performed to explore potential impact of each stratification factor on the relationship between exposure to residential green space and CVD incidence risk.Results Of the 9659 cohort participants,9004 were followed-up and 655(6.78%)were lost to follow-up by the end of the study(June 2022).During the follow-up of 49565.76 person-years(PYs)totally and 5.50±1.09 PYs averagely among the 9004 participants finally included in the analysis,overall 762 CVD cases were identified;the CVD incidence density was 153.73/10000 PYs and the CVD cumulative incidence was 8.46%.The mean values of NDVI_(250 m),NDVI_(500 m) and NDVI_(1000 m) were 0.229±0.068,0.265±0.067,and 0.298±0.060 for the followed-up participants with CVD incidence and 0.242±0.063,0.278±0.060,and 0.308±0.053 for those without CVD,respectively,with significant differences in the NDVI values between the two groups(all P<0.001).After adjusting for gender,age,education,marital status,physical activity and particulate matter less than 2.5 microns in aerodynamic diameter(PM_(2.5)),the results of GLMM model a

关 键 词：心血管疾病(CVD) 发病 住宅绿地暴露 关系 农村居民 前瞻性队列研究 

分 类 号：R54[医药卫生—心血管疾病] R12[医药卫生—内科学]