Eye-level greenspace exposure and residents’ diabetes/glucose homeostasis status in Northeast China: A gender perspective

Diabetes is a prevalent chronic disease. Its interaction with environmental factors, especially greenspace, has garnered substantial scholarly attention. However, prevailing research has yielded disparate outcomes. The objective of our research was to elucidate the association between individual eye-level greenspace exposure and diabetes risk, employing data acquired from the 33 Communities Chinese Health Study, comprising 15,477 participants in Liaoning Province, China. Greenspace exposure was measured using the Greenness Visibility Index (GVI) from street view images, while the markers of blood glucose were ascertained via a systematic oral glucose tolerance test. Our findings indicate that eye-level greenspace exposure retains a substantial inverse association with the risk of diabetes, fasting and 2-hour glucose levels. Nevertheless, no significant associations were identified between eye-level greenspace exposure and either fasting or 2-hour insulin levels when gender was not considered. However, upon taking gender into consideration, a positive association was manifested between greenspace exposure and fasting insulin levels in male subjects, while a reverse association was exhibited in females. Regarding markers of Homeostasis Model Assessment, eye-level greenspace exposure had a significant negative relationship with the HOMA-IR index, which implies a conceivable connection with diminished levels of insulin resistance. Concurrently, a positive association was discerned between eye-level greenspace exposure and the HOMA-β index, hinting at a possible relationship with augmented beta-cell functionality. Nonetheless, these associations varied across different greenspace components and gender groups. This study provides novel evidence in revealing a negative association between individual eye-level greenspace exposure in residential environments and the prevalence of diabetes. It also sheds light on the intricate relationships between eye-level greenspace exposure and diverse markers of blood glucose homeostasis.