Abstract：
BACKGROUND: This study examines longitudinal associations of air pollution and green space with cardiometabolic risk among children in the Netherlands.
METHODS: Three Dutch prospective cohorts with a total of 13,822 participants aged 5 to 17 years were included: (1) the Amsterdam Born Children and their Development (ABCD) study from Amsterdam (n = 2,547), (2) the Generation R study from Rotterdam (n = 5,431), and (3) the Lifelines study from northern Netherlands (n = 5,844). Air pollution (PM2.5, PM10, NO2, and elemental carbon (EC)) and green space exposures (density in multiple Euclidean buffer sizes) from 2006 to 2017 at home address level were used. Cardiometabolic risk factor clustering was assessed by a MetScore, which was derived from a confirmatory factor analysis of six cardiometabolic risk factors to assess the overall risk. Linear regression models with change in Metscore as the dependent variable, adjusted for multiple confounders, were conducted for each cohort separately. Meta-analyses were used to pool cohort-specific estimates.
RESULTS: Exposure to higher levels of NO2 and EC was significantly associated with increases in MetScore in Lifelines (per SD higher exposure: βNO2 = 0.006, 95 % CI = 0.001 to 0.010; βEC = 0.008, 95 % CI = 0.002 to 0.014). In the other two cohort studies, these associations were in the same direction but these were not significant. Higher green space density in 500-meter buffer zones around participants\' residential addresses was not significantly associated with decreases of MetScore in all three cohorts. Higher green space density in 2000-meter buffer zones was significantly associated with decreases of MetScore in ABCD and Lifelines (per SD higher green space density: βABCD = -0.008, 95 % CI = -0.013 to -0.003; βLifelines = -0.002, 95 % CI = -0.003 to -0.00003). The pooled estimates were βNO2 = 0.003 (95 % CI = -0.001 to 0.006) for NO2, βEC = 0.003 (95 % CI = -0.001, 0.007) for EC, and β500m buffer = -0.0014 (95 % CI = -0.0026 to -0.0001) for green space.
CONCLUSIONS: More green space exposure at residence was associated with decreased cardiometabolic risk in children. Exposure to more NO2 and EC was also associated with increased cardiometabolic risk.
METHODS: Three Dutch prospective cohorts with a total of 13,822 participants aged 5 to 17 years were included: (1) the Amsterdam Born Children and their Development (ABCD) study from Amsterdam (n = 2,547), (2) the Generation R study from Rotterdam (n = 5,431), and (3) the Lifelines study from northern Netherlands (n = 5,844). Air pollution (PM2.5, PM10, NO2, and elemental carbon (EC)) and green space exposures (density in multiple Euclidean buffer sizes) from 2006 to 2017 at home address level were used. Cardiometabolic risk factor clustering was assessed by a MetScore, which was derived from a confirmatory factor analysis of six cardiometabolic risk factors to assess the overall risk. Linear regression models with change in Metscore as the dependent variable, adjusted for multiple confounders, were conducted for each cohort separately. Meta-analyses were used to pool cohort-specific estimates.
RESULTS: Exposure to higher levels of NO2 and EC was significantly associated with increases in MetScore in Lifelines (per SD higher exposure: βNO2 = 0.006, 95 % CI = 0.001 to 0.010; βEC = 0.008, 95 % CI = 0.002 to 0.014). In the other two cohort studies, these associations were in the same direction but these were not significant. Higher green space density in 500-meter buffer zones around participants\' residential addresses was not significantly associated with decreases of MetScore in all three cohorts. Higher green space density in 2000-meter buffer zones was significantly associated with decreases of MetScore in ABCD and Lifelines (per SD higher green space density: βABCD = -0.008, 95 % CI = -0.013 to -0.003; βLifelines = -0.002, 95 % CI = -0.003 to -0.00003). The pooled estimates were βNO2 = 0.003 (95 % CI = -0.001 to 0.006) for NO2, βEC = 0.003 (95 % CI = -0.001, 0.007) for EC, and β500m buffer = -0.0014 (95 % CI = -0.0026 to -0.0001) for green space.
CONCLUSIONS: More green space exposure at residence was associated with decreased cardiometabolic risk in children. Exposure to more NO2 and EC was also associated with increased cardiometabolic risk.
摘要：
背景：这项研究调查了荷兰儿童中空气污染和绿色空间与心脏代谢风险的纵向关联。
方法：包括三个荷兰前瞻性队列，共有13,822名5至17岁的参与者：（1）阿姆斯特丹出生儿童及其发育（ABCD）研究（n=2,547），(2)鹿特丹的R代研究(n=5,431)，和(3)荷兰北部的生命线研究(n=5844)。使用了2006年至2017年家庭地址级别的空气污染（PM2.5，PM10，NO2和元素碳（EC））和绿色空间暴露（多个欧几里得缓冲区大小的密度）。心脏代谢危险因素聚类通过MetScore评估，该分析来自对6个心脏代谢危险因素的验证性因素分析,以评估总体风险.以Metscore变化为因变量的线性回归模型，针对多种混杂因素进行了调整，分别对每个队列进行。荟萃分析用于汇集队列特异性估计值。
结果：暴露于较高水平的NO2和EC与生命线MetScore的增加显着相关（每SD较高的暴露：βNO2=0.006，95％CI=0.001至0.010；βEC=0.008，95％CI=0.002至0.014）。在另外两项队列研究中，这些关联方向相同,但并不显著.参与者居住地址周围500米缓冲区中较高的绿色空间密度与所有三个队列中MetScore的降低没有显着相关。在2000米的缓冲区中，较高的绿色空间密度与ABCD和生命线的MetScore降低显着相关（每SD较高的绿色空间密度：βABCD=-0.008，95％CI=-0.013至-0.003；β生命线=-0.002，95％CI=-0.003至-0.00003）。合并的估计值为NO2的βNO2=0.003（95％CI=-0.001至0.006），EC的βEC=0.003（95％CI=-0.001，0.007），绿色空间的β500m缓冲液=-0.0014(95%CI=-0.0026至-0.0001)。
结论：居住地更多的绿地暴露与儿童心脏代谢风险降低相关。暴露于更多的NO2和EC也与心脏代谢风险增加有关。
方法：包括三个荷兰前瞻性队列，共有13,822名5至17岁的参与者：（1）阿姆斯特丹出生儿童及其发育（ABCD）研究（n=2,547），(2)鹿特丹的R代研究(n=5,431)，和(3)荷兰北部的生命线研究(n=5844)。使用了2006年至2017年家庭地址级别的空气污染（PM2.5，PM10，NO2和元素碳（EC））和绿色空间暴露（多个欧几里得缓冲区大小的密度）。心脏代谢危险因素聚类通过MetScore评估，该分析来自对6个心脏代谢危险因素的验证性因素分析,以评估总体风险.以Metscore变化为因变量的线性回归模型，针对多种混杂因素进行了调整，分别对每个队列进行。荟萃分析用于汇集队列特异性估计值。
结果：暴露于较高水平的NO2和EC与生命线MetScore的增加显着相关（每SD较高的暴露：βNO2=0.006，95％CI=0.001至0.010；βEC=0.008，95％CI=0.002至0.014）。在另外两项队列研究中，这些关联方向相同,但并不显著.参与者居住地址周围500米缓冲区中较高的绿色空间密度与所有三个队列中MetScore的降低没有显着相关。在2000米的缓冲区中，较高的绿色空间密度与ABCD和生命线的MetScore降低显着相关（每SD较高的绿色空间密度：βABCD=-0.008，95％CI=-0.013至-0.003；β生命线=-0.002，95％CI=-0.003至-0.00003）。合并的估计值为NO2的βNO2=0.003（95％CI=-0.001至0.006），EC的βEC=0.003（95％CI=-0.001，0.007），绿色空间的β500m缓冲液=-0.0014(95%CI=-0.0026至-0.0001)。
结论：居住地更多的绿地暴露与儿童心脏代谢风险降低相关。暴露于更多的NO2和EC也与心脏代谢风险增加有关。
