Association between Residential Greenness and Cardiometabolic Risk Factors among Adults in Rural Xinjiang Uygur Autonomous Region, China: A Cross-Sectional Study

Objective: This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region (Xinjiang) and thus provide a theoretical basis and data support for improving the health of residents in this region.

Methods: We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016. The normalized difference vegetation index (NDVI) was used to estimate residential greenness. The generalized linear mixed model (GLMM) was used to examine the association between residential greenness and cardiometabolic risk factors.

Results: Higher residential greenness was associated with lower cardiometabolic risk factor prevalence. After adjustments were made for age, sex, education, and marital status, for each interquartile range (IQR) increase of NDVI _500-m, the risk of hypertension was reduced by 10.3% ( OR = 0.897, 95% CI = 0.836-0.962), the risk of obesity by 20.5% ( OR = 0.795, 95% CI = 0.695-0.910), the risk of type 2 diabetes by 15.1% ( OR = 0.849, 95% CI = 0.740-0.974), and the risk of dyslipidemia by 10.5% ( OR = 0.895, 95% CI = 0.825-0.971). Risk factor aggregation was reduced by 20.4% ( OR = 0.796, 95% CI = 0.716-0.885) for the same. Stratified analysis showed that NDVI _500-m was associated more strongly with hypertension, dyslipidemia, and risk factor aggregation among male participants. The association of NDVI _500-m with type 2 diabetes was stronger among participants with a higher education level. PM ₁₀ and physical activity mediated 1.9%-9.2% of the associations between NDVI _500-m and obesity, dyslipidemia, and risk factor aggregation.

Conclusion: Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang. Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.