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Residential greenness and chronic obstructive pulmonary disease in a large cohort in southern China: Potential causal links, risk trajectories, and mediation pathways
Journal of Advanced Research ( IF 11.4 ) Pub Date : 2024-05-24 , DOI: 10.1016/j.jare.2024.05.025 Wenjing Wu , Dan Chen , Xingling Ruan , Gonghua Wu , Xinlei Deng , Wayne Lawrence , Xiao Lin , Zhiqiang Li , Ying Wang , Ziqiang Lin , Shuming Zhu , Xueqing Deng , Qiaoxuan Lin , Chun Hao , Zhicheng Du , Jing Wei , Wangjian Zhang , Yuantao Hao
Journal of Advanced Research ( IF 11.4 ) Pub Date : 2024-05-24 , DOI: 10.1016/j.jare.2024.05.025 Wenjing Wu , Dan Chen , Xingling Ruan , Gonghua Wu , Xinlei Deng , Wayne Lawrence , Xiao Lin , Zhiqiang Li , Ying Wang , Ziqiang Lin , Shuming Zhu , Xueqing Deng , Qiaoxuan Lin , Chun Hao , Zhicheng Du , Jing Wei , Wangjian Zhang , Yuantao Hao
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Residential greenness may influence COPD mortality, but the causal links, risk trajectories, and mediation pathways between them remain poorly understood. We aim to comprehensively identify the potential causal links, characterize the dynamic progression of hospitalization or posthospital risk, and quantify mediation effects between greenness and COPD. This study was conducted using a community-based cohort enrolling individuals aged ≥ 18 years in southern China from January 1, 2009 to December 31, 2015. Greenness was characterized by normalized difference vegetation index (NDVI) around participants’ residential addresses. We applied doubly robust Cox proportional hazards model, multi-state model, and multiple mediation method, to investigate the potential causal links, risk trajectories among baseline, COPD hospitalization, first readmission due to COPD or COPD-related complications, and all-cause death, as well as the multiple mediation pathways (particulate matter [PM], temperature, body mass index [BMI] and physical activity) connecting greenness exposure to COPD mortality. Our final analysis included 581,785 participants (52.52% female; Our findings revealed greenness may be a beneficial factor for COPD morbidity, prognosis, and mortality. This protective effect is primarily attributed to the reduction in PM concentration.
更新日期：2024-05-24
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