College of Nursing, University of Connecticut, Storrs, Connecticut.
Rory Myers College of Nursing, New York University, New York, New York.
Diabetes Educ. 2018 Aug;44(4):348-360. doi: 10.1177/0145721718776599. Epub 2018 May 29.
Purpose The purpose of this study is to assess the weighted prevalence and odds ratios of obesity, prediabetes, and diabetes by (1) female sexual orientation (lesbian, bisexual, and straight) with racial/ethnic (Hispanic, non-Hispanic black, and non-Hispanic white) groups combined and (2) across and within racial/ethnic groups by sexual orientation. Methods A secondary analysis of pooled 2014-2015 Behavioral Risk Factor Surveillance System data from 28 states (N = 136 878) was conducted. Rao-Scott chi-square test statistics were computed and logistic regression models were developed to assess weighted prevalence and odds ratios of obesity, prediabetes, and diabetes with adjustments for demographics (age, income, and education), depression, and health care access factors. Results With racial/ethnic groups combined, lesbian and bisexual women, relative to straight women, had a significantly increased likelihood for obesity when controlling for demographics. Bisexual women were found to have significantly reduced odds for diabetes, compared with straight women, with adjustments for demographics, depression, and health care access factors. Compared with their non-Hispanic white counterparts, Hispanic lesbian women had significantly increased odds for obesity and diabetes, while non-Hispanic black bisexual women had a significantly greater likelihood for obesity, holding demographics, depression, and health care access factors constant. Non-Hispanic white lesbian women had an increased likelihood for obesity relative to their straight, ethnic/racial counterparts. Prediabetes subsample analysis revealed the prevalence was low across all female sexual orientation groups. Conclusion Sexual minority women, particularly those of color, may be at increased risk for obesity and diabetes. Research is needed to confirm the findings.
目的 本研究旨在评估（1）女性性取向（同性恋、双性恋和异性恋）与种族/民族（西班牙裔、非西班牙裔黑人和非西班牙裔白人）相结合的肥胖、糖尿病前期和糖尿病的加权患病率和优势比；（2）通过性取向在种族/民族群体内和跨种族/民族群体评估肥胖、糖尿病前期和糖尿病的加权患病率和优势比。
方法 对 28 个州（N=136878）2014-2015 年行为风险因素监测系统数据进行了二次分析。计算了 Rao-Scott 卡方检验统计量，并建立了 logistic 回归模型，以评估肥胖、糖尿病前期和糖尿病的加权患病率和优势比，同时调整了人口统计学因素（年龄、收入和教育）、抑郁和医疗保健获取因素。
结果 与种族/民族群体相结合，在控制人口统计学因素的情况下，与异性恋女性相比，同性恋和双性恋女性肥胖的可能性显著增加。在调整人口统计学、抑郁和医疗保健获取因素后，与异性恋女性相比，双性恋女性患糖尿病的几率显著降低。与非西班牙裔白人相比，西班牙裔女同性恋者肥胖和糖尿病的几率显著增加，而非西班牙裔黑人双性恋者肥胖的几率显著增加，在保持人口统计学、抑郁和医疗保健获取因素不变的情况下。与非西班牙裔白人异性恋女性相比，非西班牙裔白人女同性恋者肥胖的几率增加。在对糖尿病前期亚组的分析中发现，所有女性性取向群体的患病率都很低。
结论 性少数女性，特别是有色人种，可能面临肥胖和糖尿病的风险增加。需要进一步研究以证实这些发现。
