Clark Cari Jo, Borowsky Iris W, Salisbury John, Usher Joann, Spencer Rachael A, Przedworski Julia M, Renner Lynette M, Fisher Colleen, Everson-Rose Susan A
Department of Medicine, Division of Epidemiology and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware Street, SE, Ste 166, Minneapolis, MN 55414, United States.
Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St., SE, Ste. 353, Minneapolis, MN 55414, United States.
Prev Med. 2015 Jul;76:26-30. doi: 10.1016/j.ypmed.2015.03.022. Epub 2015 Apr 4.
To examine long-term cardiovascular disease (CVD) risk disparities by sexual identity using a nationally representative sample of young adults in the United States.
Data include participants in wave 4 (2008/09; ages 24-34years) of the National Longitudinal Study of Adolescent to Adult Health (7087 females; 6340 males). Sexual identity was self-reported (heterosexual, mostly heterosexual, bisexual, mostly homosexual, homosexual) and a Framingham-based prediction model was used to estimate participants' risk of a CVD event over 30years. Differences in CVD risk by sexual identity, relative to heterosexuals, were calculated with linear regression models adjusted for age, race/ethnicity, education, and financial distress.
Average 30-year CVD risk was 17.2% (95% CI: 16.7, 17.7) in males and 9.0% (95% CI: 8.6, 9.3) in females. Compared to heterosexual females, mostly heterosexual (0.8%; 95% CI: 0.2, 1.4) and mostly homosexual females (2.8%; 95% CI: 0.8, 4.9) had higher CVD risk. Bisexual and homosexual females had higher but not statistically significant CVD risk compared to heterosexuals. Among males, differences in CVD risk by sexual identity were not statistically significant.
Sexual identity was associated with CVD risk in sexual minority subgroups. Population- and clinic-based prevention strategies are needed to minimize disparities in subsequent disease.
利用美国具有全国代表性的年轻成年人样本，研究按性取向划分的长期心血管疾病（CVD）风险差异。
数据包括青少年到成人健康全国纵向研究第4波（2008/09年；年龄24 - 34岁）的参与者（7087名女性；6340名男性）。性取向由参与者自我报告（异性恋、倾向异性恋、双性恋、倾向同性恋、同性恋），并使用基于弗雷明汉的预测模型来估计参与者未来30年发生心血管疾病事件的风险。通过线性回归模型计算相对于异性恋者，不同性取向的心血管疾病风险差异，并对年龄、种族/族裔、教育程度和经济困境进行了调整。
男性30年心血管疾病平均风险为17.2%（95%置信区间：16.7, 17.7），女性为9.0%（95%置信区间：8.6, 9.3）。与异性恋女性相比，倾向异性恋（0.8%；95%置信区间：0.2, 1.4）和倾向同性恋女性（2.8%；95%置信区间：0.8, 4.9）的心血管疾病风险更高。双性恋和同性恋女性与异性恋者相比，心血管疾病风险更高，但无统计学意义。在男性中，不同性取向的心血管疾病风险差异无统计学意义。
性取向与性少数群体亚组中的心血管疾病风险相关。需要基于人群和临床的预防策略，以尽量减少后续疾病的差异。
