Residential greenness and diabetes incidence in two prospective cohorts of US women

作者：Melissa Fiffer, Peter James, Jie Chen, Hari S. Iyer, Isabel Holland, Charlotte Roscoe, Grete E. Wilt, Rachel C. Nethery, Qi Sun, Francine Laden, Jaime E. Hart · 发表于：Environmental Epidemiology · 年份：2025 · DOI：10.1097/ee9.0000000000000405 · 被引用次数：4 · 研究领域：Urban Green Space and Health、Health disparities and outcomes、Environmental Justice and Health Disparities

Background: Epidemiologic studies have associated higher neighborhood greenness with lower type 2 diabetes (T2D) risk. However, more work is needed to assess interrelationships between greenness, T2D risk factors, and T2D. Our aim was to prospectively evaluate the association between greenness and T2D incidence, and investigate effect modifiers, in the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII) cohorts of US women. Methods: Greenness exposure was defined using the normalized difference vegetation index (NDVI), a quantitative indicator of photosynthetic vegetation. We obtained 30m 2 resolution Landsat satellite data and calculated average NDVI within 270 m and 1230 m radial buffers to represent residential exposure and exposure within a short walk/drive using addresses from 1992 to 2017. We used time-varying Cox proportional hazards models to assess summer average NDVI in the 2 years before diagnosis and self-reported, validated clinician T2D diagnosis through 2019. We adjusted for time-varying covariates including lifestyle factors, hormone use, individual and neighborhood socioeconomic status (nSES), population density, particulate matter (PM) 2.5 and nitrogen dioxide (NO 2 ) exposure, and baseline body mass index (BMI). Results from the two cohorts (n = 212,548) were meta-analyzed. We examined effect modification by time-varying BMI, physical activity, smoking, region, air pollution, population density, and nSES. Supplemental analyses explored mediation ...