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年轻人心血管生物标志物的性取向差异。

Sexual orientation disparities in cardiovascular biomarkers among young adults.

机构信息

Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.

出版信息

Am J Prev Med. 2013 Jun;44(6):612-21. doi: 10.1016/j.amepre.2013.01.027.

Abstract

BACKGROUND

Emerging evidence from general population studies suggests that lesbian, gay, and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. No studies have examined whether sexual orientation disparities exist in biomarkers of early cardiovascular disease risk.

PURPOSE

To determine whether sexual orientation disparities in biomarkers of early cardiovascular risk are present among young adults.

METHODS

Data come from Wave IV (2008-2009) of the National Longitudinal Study for Adolescent Health (N=12,451), a prospective nationally representative study of U.S. adolescents followed into young adulthood (mean age=28.9 years). A total of 520 respondents identified as lesbian, gay, or bisexual. Biomarkers included C-reactive protein, glycosylated hemoglobin, systolic and diastolic blood pressure, and pulse rate. Analyses were conducted in 2012.

RESULTS

In gender-stratified models adjusted for demographics (age, race/ethnicity); SES (income, education); health behaviors (smoking, regular physical activity, alcohol consumption); and BMI, gay and bisexual men had significant elevations in C-reactive protein, diastolic blood pressure, and pulse rate, compared to heterosexual men. Despite having more risk factors for cardiovascular disease, including smoking, heavy alcohol consumption, and higher BMI, lesbians and bisexual women had lower levels of C-reactive protein than heterosexual women in fully adjusted models.

CONCLUSIONS

Evidence was found for sexual orientation disparities in biomarkers of cardiovascular risk among young adults, particularly in gay and bisexual men. These findings, if confirmed in other studies, suggest that disruptions in core physiologic processes that ultimately confer risk for cardiovascular disease may occur early in the life course for sexual-minority men.

摘要

背景

来自一般人群研究的新证据表明,与异性恋者相比,同性恋、双性恋和无性恋(LGB)成年人更有可能经历不良心血管结局。目前尚无研究探讨性取向差异是否存在于早期心血管疾病风险的生物标志物中。

目的

确定在年轻成年人中,早期心血管风险的生物标志物是否存在性取向差异。

方法

数据来自全国青少年纵向研究(N = 12451)的第四波(2008-2009 年),这是一项对美国青少年进行的前瞻性全国代表性研究,随访至成年早期(平均年龄 28.9 岁)。共有 520 名受访者被认定为同性恋、双性恋或无性恋。生物标志物包括 C 反应蛋白、糖化血红蛋白、收缩压和舒张压以及脉搏率。分析于 2012 年进行。

结果

在按性别分层的模型中,调整了人口统计学因素(年龄、种族/族裔);SES(收入、教育);健康行为(吸烟、定期体育锻炼、饮酒);以及 BMI,与异性恋男性相比,男同性恋和双性恋男性的 C 反应蛋白、舒张压和脉搏率显著升高。尽管存在更多心血管疾病的风险因素,包括吸烟、大量饮酒和更高的 BMI,但在完全调整的模型中,女同性恋和双性恋女性的 C 反应蛋白水平低于异性恋女性。

结论

在年轻成年人的心血管风险生物标志物中发现了性取向差异的证据,尤其是在男同性恋和双性恋男性中。如果在其他研究中得到证实,这些发现表明,核心生理过程的中断可能会在性少数男性的生命早期就导致心血管疾病的风险。

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