摘要：AbstractBackgroundMenopause is associated with a number of adverse health effects and its timing has been reported to be influenced by several lifestyle factors. Whether greenspace exposure is associated with age at menopause has not yet been investigated.ObjectiveTo investigate whether residential surrounding greenspace is associated with age at menopause and thus reproductive aging.MethodsThis longitudinal study was based on the 20-year follow-up of 1955 aging women from a large, population-based European cohort (ECRHS). Residential surrounding greenspace was abstracted as the average of satellite-based Normalized Difference Vegetation Index (NDVI) across a circular buffer of 300 m around the residential addresses of each participant during the course of the study. We applied mixed effects Cox models with centre as random effect, menopause as the survival object, age as time indicator and residential surrounding greenspace as time-varying predictor. All models were adjusted for smoking habit, body mass index, parity, age at menarche, ever-use of contraception and age at completed full-time education as socio-economic proxy.ResultsAn increase of one interquartile range of residential surrounding greenspace was associated with a 13% lower risk of being menopausal (Hazard Ratio: 0.87, 95% Confidence Interval: 0.79–0.95). Correspondingly the predicted median age at menopause was 1.4 years older in the highest compared to the lowest NDVI quartile. Results remained stable after additional adjustment for air pollution and traffic related noise amongst others.ConclusionsLiving in greener neighbourhoods is associated with older age at menopause and might slow reproductive aging. These are novel findings with broad implications. Further studies are needed to see whether our findings can be replicated in different populations and to explore the potential mechanisms underlying this association.Highlights•There are no pre-existing studies on greenspace and reproductive aging.•More residential surrounding greenspace is associated with older age at menopause.•This study provides evidence for interventions towards slowing reproductive aging
关键词：AbbreviationsBMIbody mass index;CIConfidence Interval;ECRHSEuropean Community Respiratory Health Survey;FSHFollicle Stimulating Hormone;HRHazard Ratio;HRThormone replacement therapy;IQRinterquartile range;IU/LInternational Units per Litre;NDVINormalized Difference Vegetation Index;NIRnear-infrared light;PCOSpolycystic ovary syndrome;pmol/LPicomol per Litre;REDvisible red light;Greenspace;Menopause;NDVI;Reproductive aging;Sex hormones
