| Title: | Residential green space and transition trajectory of cardiometabolic multimorbidity in two prospective cohorts |
| Journal: | Urban Forestry & Urban Greening |
| Published: | 1 Oct 2025 |
| DOI: | https://doi.org/10.1016/j.ufug.2025.128966 |
Publication 16593
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Abstract
The relationship of residential green space with single cardiometabolic diseases (CMDs) has been the focus in previous studies, but effect of residential green space on development of cardiometabolic multimorbidity (CMM) remains uncertain. We included participants from the UK Biobank (n = 255,725) and Yinzhou cohort (n = 21,626) in China. Residential green space was assessed using land use and satellite remote sensing data. CMM was characterized by consisting of ≥ 2 CMDs, specifically stroke, ischemic heart disease and type 2 diabetes. Multi-state model was employed to examine the relationship between residential green space and transition trajectories of CMM. Over median follow-up periods of 13.35 and 5.48 years, a total of 37,713 (14.75 %) and 4156 (19.22 %) individuals experienced the occurrence of at least one CMD in the UKB and Yinzhou cohort, respectively. Among these individuals, 6060 (16.07 %) and 474 (11.41 %) subsequently developed CMM. We observed relationships between residential green space and reduced risk of multiple transitions. In the UKB, hazard ratios (HRs) and 95 % confidence intervals (CIs) for various transitions related to each interquartile range increase in green space within a 1000-m buffer were as follows: 0.96 (0.95, 0.98) for the transition from baseline to first cardiometabolic disease (FCMD), 0.92 (0.88, 0.96) for the transition from FCMD to CMM, 0.95 (0.90, 0.99) for the transition from FCMD to death, and 0.90 (0.83, 0.98) for the transition from CMM to death. Similar findings were observed for different buffer radii (300-m) and Yinzhou cohort. Our study indicated inverse association of residential green space with risk of multiple transitions based on two prospective cohorts from different areas. Furthermore, the protective effect of residential green space seems to be more pronounced for severe transition stages of CMM.</p>
16 Authors
- Yonghao Wu
- Jiacheng Ying
- Yexiang Sun
- Lisha Xu
- Zihan Li
- Jiayun Zhang
- Jie Qiu
- Yixing Wang
- Jingjing Hu
- Peng Shen
- Hongbo Lin
- Liming Shui
- Ding Ye
- Yingying Mao
- Kun Chen
- Jianbing Wang
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