BACKGROUND Land-use changes in city fringes due to urbanization can lead to a reduction of greenspace that may reduce its associated health benefits. OBJECTIVES We evaluated the association between changes in residential surrounding built-up land use and cardiometabolic risk factors in an urbanizing peri-urban area of south India and explored the mediating roles of air pollution, physical activity, and stress in these associations. METHODS We analyzed data on 6,039 adults from the third follow-up of the Andhra Pradesh Children and Parent Study (APCAPS) cohort (2010-2012). We generated trajectories of change in residential surrounding built-up land use (buffer areas) from 1995-2009 (stable, slow increase, fast increase) using remote sensing data and image classification methods. We estimated associations between built-up land use trajectories and natural log-transformed blood pressure, waist circumference, triglycerides, fasting glucose, and non-high-density lipoprotein (non-HDL) cholesterol using linear mixed models. We accounted for multiple mediators and the multilevel structure of the data in mediation analyses. RESULTS We observed positive associations between a fast increase in built-up land use within 300m of the home and all cardiometabolic risk factors. Compared with participants with stable trajectories, those with the largest increase in built-up land use had 1.5% (95% CI: 0.1, 2.9) higher systolic blood pressure, 2.4% (95% CI: 0.6, 4.3) higher diastolic blood pressure, 2.1% (95% CI: 0.5, 3.8) higher waist circumference, and 1.6% (95% CI: -0.6, 3.8) higher fasting glucose in fully adjusted models. Associations were positive, but not statistically significant, for triglycerides, fasting glucose, and non-HDL cholesterol. Physical activity and ambient particulate matter ≤2.5μm in aerodynamic diameter (PM2.5) partially mediated the estimated associations. Associations between fast build-up and all cardiometabolic risk factors except non-HDL cholesterol were stronger in women than men. DISCUSSION Increases in built-up land use surrounding residences were consistently associated with higher levels of cardiometabolic risk factors. Our findings support the need for better integration of health considerations in urban planning in rapidly urbanizing settings. https://doi.org/10.1289/EHP5445.

中文翻译：

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印度南部城市化地区的土地利用变化和心脏代谢风险因素：一项基于人口的队列研究。

背景技术城市化导致的城市边缘土地利用变化会导致绿色空间减少，这可能会降低其相关的健康效益。目标 我们评估了印度南部城市化城市周边地区住宅周边建成用地使用变化与心脏代谢风险因素之间的关联，并探讨了空气污染、体育活动和压力在这些关联中的中介作用。方法 我们分析了来自安得拉邦儿童和家长研究 (APCAPS) 队列（2010-2012）第三次随访的 6,039 名成年人的数据。我们使用遥感数据和图像分类方法生成了 1995-2009 年住宅周边建成用地（缓冲区）变化的轨迹（稳定、缓慢增加、快速增加）。我们使用线性混合模型估计了建成土地利用轨迹与自然对数转换血压、腰围、甘油三酯、空腹血糖和非高密度脂蛋白 (non-HDL) 胆固醇之间的关联。我们在中介分析中考虑了多个中介和数据的多层次结构。结果 我们观察到住宅 300m 范围内建筑用地使用的快速增加与所有心脏代谢风险因素之间存在正相关。与轨迹稳定的参与者相比，建成土地利用增加最多的参与者收缩压高 1.5% (95% CI: 0.1, 2.9)，舒张压高 2.4% (95% CI: 0.6, 4.3) , 2.1% (95% CI: 0.5, 3.8) 腰围高，空腹血糖高 1.6% (95% CI: -0.6, 3.8)。甘油三酯、空腹血糖和非高密度脂蛋白胆固醇的相关性呈阳性，但没有统计学意义。身体活动和空气动力学直径 (PM2.5) ≤2.5μm 的环境颗粒物部分介导了估计的关联。除了非高密度脂蛋白胆固醇外，快速积聚与所有心脏代谢风险因素之间的关联在女性中比男性更强。讨论 住宅周围建筑用地的增加始终与较高水平的心脏代谢风险因素相关。我们的研究结果支持在快速城市化环境中更好地将健康考虑纳入城市规划的必要性。https://doi.org/10.1289/EHP5445。身体活动和空气动力学直径 (PM2.5) ≤2.5μm 的环境颗粒物部分介导了估计的关联。除了非高密度脂蛋白胆固醇外，快速积聚与所有心脏代谢风险因素之间的关联在女性中比男性更强。讨论 住宅周围建筑用地的增加始终与较高水平的心脏代谢风险因素相关。我们的研究结果支持在快速城市化环境中更好地将健康考虑纳入城市规划的必要性。https://doi.org/10.1289/EHP5445。身体活动和空气动力学直径 (PM2.5) ≤2.5μm 的环境颗粒物部分介导了估计的关联。除了非高密度脂蛋白胆固醇外，快速积聚与所有心脏代谢风险因素之间的关联在女性中比男性更强。讨论 住宅周围建筑用地的增加始终与较高水平的心脏代谢风险因素相关。我们的研究结果支持在快速城市化环境中更好地将健康考虑纳入城市规划的必要性。https://doi.org/10.1289/EHP5445。讨论 住宅周围建筑用地的增加始终与较高水平的心脏代谢风险因素相关。我们的研究结果支持在快速城市化环境中更好地将健康考虑纳入城市规划的必要性。https://doi.org/10.1289/EHP5445。讨论 住宅周围建筑用地的增加始终与较高水平的心脏代谢风险因素相关。我们的研究结果支持在快速城市化环境中更好地将健康考虑纳入城市规划的必要性。https://doi.org/10.1289/EHP5445。