Associations between residential greenness and blood lipids in Chinese Uyghur adults

•The first study to examine the effect of greenness on blood lipids in rural areas.•Higher greenness exposure was associated with lower TG and higher HDL-C levels.•Higher greenness exposure was associated with lower odds of hypoalphalipoproteinemia.•The associations were stronger in women or those with higher education level. Dyslipidemia is a major risk factor for cardiovascular disease. Several studies have explored the associations of greenness with blood lipids. However, the evidence is still limited and mixed, especially in rural areas. From May to September 2016, we recruited 4735 Uyghur adults from rural areas of northwestern China. We measured levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Two satellite-derived vegetation indices — Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) — were used to estimate residential greenness levels. The associations between exposure to residential greenness and blood lipids levels and dyslipidemia prevalence were examined using the Generalized Linear Mixed Models. Living in greener areas was associated with lower TG levels, higher HDL-C levels, and lower odds of hypoalphalipoproteinemia (e.g., per 0.20-unit increase in NDVI100 m was associated with 0.02 mmol/L (95% CI: 0.001, 0.03) higher levels of HDL-C and 0.87-fold (95% CI: 0.77, 0.98) lower odds of hypoalphalipoproteinemia). These associations remained in a series of sensitivity analyses. Stratified analyses showed that the associations of NDVI100 m with LDL-C and HDL-C levels were stronger in women and in participants with higher education level. Higher greenness exposure was beneficially associated with blood lipids among rural Uyghur population in China, especially among women or those with higher education level.