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Evidence on gene-environment interaction is limited, mainly cross-sectional, and largely from European-ancestry populations. Prospective data from Chinese populations examining the association between residential greenness and incident T2D, as well as glycemic traits, are scarce. In this study, we included 7861 middle-aged and older Chinese adults (aged \u2265 40\u2009years), and assessed residential greenness using the Normalized Difference Vegetation Index (NDVI) derived from Moderate-Resolution Imaging Spectroradiometer (MODIS) satellite imagery, linking it to T2D incidence over a median follow-up of 3.8\u2009years. Genetic susceptibility was assessed in 5389 participants with DNA data using a T2D-specific weighted genetic risk score based on 89 genome-wide significant single-nucleotide polymorphisms identified in East Asian populations, weighted by published effect estimates. Our results show that higher residential greenness was associated with a 44% reduction in T2D risk (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.48\u20130.66), as well as improved insulin sensitivity and \u03b2-cell function. Notably, genetic susceptibility significantly modified the association between residential greenness and T2D on both multiplicative (P for interaction\u2009=\u20090.019) and additive scales (relative excess risk due to interaction [RERI] = 0.19), with higher greenness conferring greater relative and absolute risk reductions among individuals at medium and high genetic risk. These findings underscore a protective role of residential greenness against T2D, with stronger effects in those at higher genetic risk, supporting environmental interventions to mitigate genetic predisposition in the prevention of T2D.<\/jats:p>","DOI":"10.1093\/lifemeta\/loag019","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:21:20Z","timestamp":1783336880000},"source":"Crossref","is-referenced-by-count":0,"title":["Joint effects of residential greenness and genetic susceptibility on type 2 diabetes: a prospective cohort study using satellite-derived Normalized Difference Vegetation Index"],"prefix":"10.1093","volume":"5","author":[{"given":"Yonghua","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]},{"name":"Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the P.R. China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junru","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]},{"name":"Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the P.R. China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]},{"name":"Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the P.R. China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Li","sequence":"additional","affiliation":[{"name":"Institute for Urban Governance and Sustainable Development, Tsinghua University , Beijing 100084,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]},{"name":"Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the P.R. China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Ye","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, Zhejiang 310051,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruizhi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]},{"name":"Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the P.R. 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China, Shanghai National Center for Translational Medicine, Shanghai Digital Medicine Innovation Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026091805562608600_loag019-B1","volume-title":"IDF Diabetes Atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050. Lancet Diabetes Endocrinol 2025;14:149\u201356.","author":"Genitsaridi I, Salpea P, Salim A et al."},{"key":"2026091805562608600_loag019-B2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12916-017-0901-x","article-title":"Environmental\/lifestyle factors in the patho\u00adgenesis and prevention of type 2 diabetes","volume":"15","author":"Kolb","year":"2017","journal-title":"BMC Med"},{"key":"2026091805562608600_loag019-B3","doi-asserted-by":"crossref","first-page":"e405","DOI":"10.1097\/EE9.0000000000000405","article-title":"Residential greenness and diabetes incidence in two prospective cohorts of US women","volume":"9","author":"Fiffer","year":"2025","journal-title":"Environ Epidemiol"},{"key":"2026091805562608600_loag019-B4","doi-asserted-by":"crossref","first-page":"e302","DOI":"10.1097\/EE9.0000000000000302","article-title":"Air pollution, traffic noise, greenness, and temperature and the risk of incident type 2 diabetes: results from the KORA cohort study","volume":"8","author":"Badpa","year":"2024","journal-title":"Environ Epidemiol"},{"key":"2026091805562608600_loag019-B5","doi-asserted-by":"crossref","first-page":"115215","DOI":"10.1016\/j.envres.2023.115215","article-title":"Association between greenness and cardiovascular risk factors: results from a large cohort study in Thailand","volume":"220","author":"Paoin","year":"2023","journal-title":"Environ Res"},{"key":"2026091805562608600_loag019-B6","doi-asserted-by":"crossref","first-page":"119821","DOI":"10.1016\/j.envpol.2022.119821","article-title":"Long-term exposure to residential surrounding greenness and incidence of diabetes: a prospective cohort study","volume":"310","author":"Yu","year":"2022","journal-title":"Environ Pollut"},{"key":"2026091805562608600_loag019-B7","doi-asserted-by":"crossref","first-page":"107570","DOI":"10.1016\/j.envint.2022.107570","article-title":"Air pollution, road traffic noise and lack of greenness and risk of type 2 diabetes: a multi-exposure prospective study covering Denmark","volume":"170","author":"Sorensen","year":"2022","journal-title":"Environ Int"},{"key":"2026091805562608600_loag019-B8","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12940-021-00824-w","article-title":"Neighborhood greenspace and risk of type 2 diabetes in a prospective cohort: the multi-ethnicity study of atherosclerosis","volume":"21","author":"Doubleday","year":"2022","journal-title":"Environ Health"},{"key":"2026091805562608600_loag019-B9","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ijheh.2018.12.001","article-title":"Associations of greenness with diabetes mellitus and glucose-homeostasis markers: the 33 communities Chinese health study","volume":"222","author":"Yang","year":"2019","journal-title":"Int J Hyg Environ Health"},{"key":"2026091805562608600_loag019-B10","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1136\/bjsports-2012-092006","article-title":"Green space is associated with walking and moderate-to-vigorous physical activity (MVPA) in middle-to-older-aged adults: findings from 203 883 Australians in the 45 and up study","volume":"48","author":"Astell-Burt","year":"2014","journal-title":"Br J Sports Med"},{"key":"2026091805562608600_loag019-B11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.2337\/dc13-1325","article-title":"Is neighborhood green space associated with a lower risk of type 2 diabetes? 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