Independent and interactive associations of green space and air pollution with blood lipid biomarkers: A longitudinal study.

Authors

Jing Xu, Yishu Li, Guoqiang Ma, Yuefei Wu, Qian Li, Xuan Cao, Zitong Zhao, Jingyan Gao, Lijun Gao, Lina Yan, Xiaolin Zhang

Published in

Ecotoxicology and environmental safety. Volume 322. Pages 120475. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

Evidence on the independent and interactive associations of green space and air pollution with novel blood lipid biomarkers remains limited. This longitudinal cohort study aimed to examine the independent and interactive associations of green space and air pollution exposure with blood lipid biomarkers.
The study included 17,242 adults undergoing health examinations in Shijiazhuang, China (2021-2023). Linear mixed-effects models estimated associations of green space and air pollution exposure with blood lipid biomarkers, including the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and the atherogenic index of plasma (AIP). Interaction terms, restricted cubic splines, and mediation analyses evaluated interaction effects, nonlinear exposure-response relationships, and mediation effects.
Associations with green space were most pronounced within the 500-m buffer. Each one-standard deviation (SD) increase in NDVI was associated with lower NHHR (β = -0.103; 95% CI: -0.114, -0.091) and AIP (β = -0.009; 95% CI: -0.012, -0.006). Among air pollutants, PM₂.₅ showed a stronger positive association with NHHR (β = 0.085 per SD; 95% CI: 0.081, 0.089), whereas PM₁₀ exhibited a stronger association with AIP (β = 0.006 per SD; 95% CI: 0.005, 0.007). Significant interactions were observed between NDVI and multiple air pollutants for both biomarkers (P_interaction < 0.05). Air pollution mixture indices statistically mediated part of the associations between green space exposure and NHHR (13.5%) and AIP (34%).
Green space exposure was associated with more favorable lipid biomarkers, whereas air pollution showed adverse associations. Green space is associated with weaker air pollution-related dyslipidemia.

PMID:
42407152
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.

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