Residential greenness associated with decreased risk of metabolic- dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study

Lin Chen; Yiping Jia; Yuming Guo; Gongbo Chen; Zhuoga Ciren; Heng Chen; Zhuoma Duoji; Jie Xu; Tingting Yang; Huan Xu; Shiyu Feng; Ye Jiang; Bing Guo; Qiong Meng; Xing Zhao

doi:10.1016/j.ecoenv.2022.114338

Residential greenness associated with decreased risk of metabolic- dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study

Ecotoxicol Environ Saf. 2023 Jan 1:249:114338. doi: 10.1016/j.ecoenv.2022.114338. Epub 2022 Dec 9.

Authors

Lin Chen¹, Yiping Jia², Yuming Guo³, Gongbo Chen⁴, Zhuoga Ciren⁵, Heng Chen⁶, Zhuoma Duoji⁷, Jie Xu⁸, Tingting Yang⁹, Huan Xu¹, Shiyu Feng¹, Ye Jiang¹, Bing Guo¹⁰, Qiong Meng¹¹, Xing Zhao¹²

Affiliations

¹ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
² Department of Ultrasound, West China School of Public Health and West China Fourth Hospital, Sichuan, China.
³ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
⁴ Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
⁵ Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China.
⁶ Chengdu Center for Disease Control & Prevention, China.
⁷ School of Medicine, Tibet University, Lhasa, Tibet, China.
⁸ Chongqing Municipal Center for Disease Control and Prevention, China.
⁹ School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China.
¹⁰ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: guobing0111@foxmail.com.
¹¹ Department of Epidemiology and Health Statistics School of Public Health, Kunming Medical University, West Chunrong Road, Chenggong Zone, Kunming, Yunnan 650500, China. Electronic address: mengqiong2006@163.com.
¹² West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: xingzhao@scu.edu.cn.

PMID: 36508840
DOI: 10.1016/j.ecoenv.2022.114338

Abstract

Background: Numerous studies have shown that residential greenness positively correlates with enhanced health. Metabolic dysfunction-associated fatty liver disease (MAFLD) affects about a quarter of the population while lacking specific treatments. Given that the association between green space and MAFLD is still unknown, we explored the association between residential greenness and MAFLD as well as the potential mechanisms based on the baseline survey of the China Multi-Ethnic Cohort (CMEC).

Methods: Residential greenness was expressed as normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). MAFLD was assessed through hepatic steatosis, the presence of overweight/obesity, type 2 diabetes mellitus, and evidence of metabolic dysregulation. We used logistic regression to examine the association between NDVI/EVI and the prevalence of MAFLD. Moreover, we utilized causal mediation analyses to explore the role of physical activity and ambient particulate matters (PM₁, PM_2.5, and PM₁₀) on the association between residential greenness and MAFLD.

Results: We included 72,368 participants from the CMEC and found that residential greenness was negatively associated with the prevalence of MAFLD. For an interquartile range (IQR) increase in NDVI_{500 m} and EVI_{500 m}, the odds ratio (OR) of MAFLD were 0.78 (95 %CI: 0.75, 0.81) and 0.81 (95 %CI: 0.78, 0.84), respectively. Greater association between residential greenness and MAFLD was observed among males. Air pollutants and physical activity could mediate a partial effect (8.5-22.9 %) of residential greenness on MAFLD.

Conclusion: Higher residential greenness was associated with decreased risk of MAFLD. Moreover, the association was greater among males. The protective effects of residential greenness may be achieved by mitigating the hazardous effects of air pollutants and encouraging physical activity.

Keywords: Epidemiological study; Greenness; Metabolic dysfunction-associated fatty liver disease.

MeSH terms

Air Pollutants*
Air Pollution* / analysis
China / epidemiology
Diabetes Mellitus, Type 2*
Epidemiologic Studies
Humans
Male
Non-alcoholic Fatty Liver Disease*
Obesity / epidemiology
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter