蚌埠市社区绿地暴露与成年居民糖尿病患病率的关系: BMI的中介作用

  目的  了解蚌埠市龙子湖区社区绿地暴露与糖尿病(diabetes mellitus, DM)患病率的相关性，并探讨BMI在社区绿地暴露与DM之间的中介效应。  方法  2015年8月，采用分层随机抽样，调查蚌埠市龙子湖区成年居民3 354人。居民基本信息以问卷形式收集，社区绿地暴露用归一化植被指数(normalized difference vegetation index，NDVI)和土壤调整植被指数(soil adjusted vegetation index，SAVI)1 000 m缓冲区的值表示。用二分类Logistic回归分析探究社区绿地暴露与DM的相关性，并评估BMI的中介效应。  结果  NDVI-1 000 m (χ2=36.39, P < 0.001)与SAVI-1 000 m(χ2=20.14, P < 0.001)不同组之间患病率均存在统计学差异。调整模型下，NDVI-1 000 m和SAVI-1 000 m Q3组患病率分别是Q1组的0.538倍(OR=0.538，95% CI: 0.388~0.745)和0.605倍(OR=0.605，95% CI: 0.440~0.833)。BMI在NDVI-1 000 m和SAVI-1 000 m与DM的关联分别存在6.42%(95% CI: 1.83%~16.00%)和7.43%(95% CI: 2.36%~19.00%)的中介效应。  结论  社区绿地暴露越高，DM患病率越低。BMI在社区绿地暴露与DM之间有中介效应。

Association of neighborhood greenness exposure and diabetes mellitus among adults in Bengbu:the mediation of body mass index

  Objective  This study aims to evaluate the association between neighborhood greenness exposure and diabetes mellitus (DM) among adults in Longzihu District, Bengbu City, and to explore the mediating effect of BMI on neighborhood greenness exposure with DM.  Methods  In 2015, 3 354 adult residents in Longzihu District were recruited. Basic information was obtained by questionnaire survey. Normalized difference vegetation index (NDVI) and soil adjusted vegetation index (SAVI) values with 1000 m buffers were used to evaluate neighborhood greenness exposure. Binary Logistic regression was conducted to assess the association between neighborhood greenness exposure and DM. In addition, this study assessed the mediating effects of BMI on neighborhood greenness exposure with DM.  Results  There were significant differences in the prevalence of DM among different groups in NDVI-1 000m (χ2=36.39, P < 0.001) and SAVI-1 000m (χ2=20.14, P < 0.001). In the fully adjusted model, the prevalence of DM in the Q3 group was 0.538 (OR=0.538, 95% CI: 0.388-0.745) and 0.605 (OR=0.605, 95% CI: 0.440-0.833) compared to the Q1 group under NDVI-1 000 m and SAVI-1 000 m, respectively. The BMI mediated 6.42% (95% CI: 1.83%-16.00%) on NDVI-1 000m with DM and 7.43% (95% CI: 2.36%-19.00%) on SAVI-1 000 m with DM.  Conclusion  The higher the neighborhood greenness exposure, the lower the prevalence of DM. BMI was a mediating factor between neighborhood greenness exposure with DM.