Association and Interaction of Neighborhood Environment and Social Factors With Blood Glucose Among Adult Residents: A Cross-Sectional Study.

BACKGROUND AND AIMS: High fasting blood glucose (FBG) ranks fifth among the global risk factors for disease burden, influenced by both individual and environmental factors. However, the roles of social and neighborhood environmental factors remain underexplored in China. This study aimed to estimate the relationship between neighborhood environment, social factors, and FBG among adult residents, and explore potential interaction. METHODS: This cross-sectional study included 440 participants from two public hospitals in China. We collected data on social factors, FBG, and participant characteristics using electronic questionnaires, anthropometric measurements, and physical examination. The neighborhood environment features were measured using the geographic information systems (GIS) methods. Linear regression analysis was used to examine associations between neighborhood environment features and social factors and FBG. RESULTS: This study found that marital status (married VS unmarried; β = 0.21, p < 0.001) and the highest quartile of residential housing density (Q4 vs Q1, β = 0.16, p = 0.03) had significant associations with higher FBG levels. The quartiles of the normalized difference vegetation index (NDVI) (Q2, β = -0.14, p = 0.04; Q3, β = -0.19, p = 0.004; Q4, β = -0.21, p = 0.003) and sports facility density (Q2, β = -0.18, p = 0.002; Q3, β = -0.20, p = 0.008; Q4, β = -0.30, p < 0.001) were significantly associated with lower FBG. Furthermore, the second, third, and fourth quartiles of sports facility density and the fourth quartile of residential housing density showed stronger associations with FBG by the interaction with educational level (high vs low). There were also significant interaction effects between residential housing density and subjective economic status, and between NDVI and marital status on FBG. CONCLUSION: This study suggests that marital status, residential greenness, and densities of sports facility and residential housing are associated with FBG, and demonstrates potential interaction. Future research is necessary to further clarify these relationships and explore the underlying mechanisms.