Associations and pathways between residential greenness and hyperuricemia among adults in rural and urban China

Residential greenness may decrease the risk for hyperuricemia in rural areas, but the urban-rural disparities in this association and underlying pathways have not been studied.To investigate the associations and potential pathways between residential greenness and hyperuricemia in urban and rural areas.The baseline survey of the China Multi-Ethnic Cohort (CMEC) was used. Hyperuricemia was defined as serum uric acid (SUA) 417 μmol/L for men and357 μmol/L for women. The satellite-based normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) were used to capture residential greenness. A propensity score inverse-probability weighting method was used to assess urban-rural differences in the associations between residential greenness and hyperuricemia, with possible mediation effects of physical activity (PA), body mass index (BMI), PMA total of 72,372 participants were included. The increases in the EVIExposure to residential greenness was associated with a decreased risk for hyperuricemia, partially through the pathways of PA, BMI, PM