同性恋、双性恋成年人慢性生理应激效应：来自国家健康和营养调查的结果。
Chronic Physiologic Effects of Stress Among Lesbian, Gay, and Bisexual Adults: Results From the National Health and Nutrition Examination Survey.
机构信息
From the Departments of Psychology and Health Policy and Management (Mays), Fielding School of Public Health University of California, Los Angeles; University of Montreal, Department of Psychiatry and Addiction (Juster), Montreal; University of California, Los Angeles (Williamson); UCLA School of Medicine and Fielding School of Public Health (Seeman), University of California, Los Angeles; and Department of Epidemiology, Fielding School of Public Health and Department of Statistics (Cochran), University of California, Los Angeles.
出版信息
Psychosom Med. 2018 Jul/Aug;80(6):551-563. doi: 10.1097/PSY.0000000000000600.
OBJECTIVE
Social disadvantage is associated with markers of physiological dysregulation, which is linked to disease trajectories. Chronic experiences with discrimination are thought to result in the accumulation of physiological "wear and tear" known as allostatic load (AL) among socially marginalized populations such as sexual minorities. Using a nationally representative US sample, we examined whether (1) people who self-identified as homosexual or bisexual display higher levels of AL than heterosexual individuals and (2) subgroups of sexual identity would further differ from each other as a consequence of distinct experiences of marginalization.
METHODS
We use data from the 2001-2010 National Health and Nutrition Examination Survey. Employing multivariate regression methods with sex-specific analyses, we examined AL score differences among lesbian/gay (n = 211), bisexual (n = 307), homosexually experienced (n = 424), and exclusively heterosexual (n = 12,969) individuals, adjusting for possible confounding due to demographics, health indicators, and, among men, HIV infection status.
RESULTS
Results indicate that elevated AL was more common in bisexual men compared with exclusively heterosexual men (adjusted β = 0.25, 95% confidence interval [CI] = 0.05 to 0.44), with significantly higher levels of glycosylated hemoglobin A1c (adjusted odd ratio = 3.51, 95% CI = 1.46-7.92) and systolic blood pressure (adjusted odd ratio = 2.07, 95% CI = 1.02 to 4.18). Gay-identified men evidenced significantly lower AL (adjusted β = -0.22, 95% CI = -0.41 to -0.04). No significant differences in AL were observed among women.
CONCLUSIONS
These findings indicate that physiological dysregulation is more common in bisexual males compared with all other men. The results are discussed with regard to differences in health outcomes between individuals with different sexual orientations.
目的
社会劣势与生理失调的标志物有关，而生理失调与疾病轨迹有关。据认为，慢性歧视经历会导致社会边缘化人群（如性少数群体）的生理“磨损”积累，这种现象被称为适应负荷（AL）。本研究使用具有全国代表性的美国样本，检验了以下两个问题：（1）自我认同为同性恋或双性恋的人是否比异性恋者表现出更高水平的 AL；（2）性认同亚组是否会因边缘化的不同经历而进一步彼此不同。
方法
我们使用了 2001-2010 年全国健康与营养调查的数据。通过性别特异性分析的多元回归方法，我们检查了同性恋/双性恋者（n=211）、双性恋者（n=307）、同性恋经历者（n=424）和异性恋者（n=12969）的 AL 评分差异，同时调整了人口统计学、健康指标和男性中的 HIV 感染状况等混杂因素的影响。
结果
结果表明，与异性恋男性相比，双性恋男性的 AL 水平更高（调整后β=0.25，95%置信区间[CI]为 0.05-0.44），糖化血红蛋白 A1c 水平更高（调整后比值比[OR]=3.51，95%CI 为 1.46-7.92），收缩压水平更高（调整后 OR=2.07，95%CI 为 1.02-4.18）。同性恋男性的 AL 水平显著较低（调整后β=-0.22，95%CI=-0.41 至-0.04）。女性中没有观察到 AL 水平的显著差异。
结论
这些发现表明，与其他男性相比，双性恋男性的生理失调更为常见。结果根据不同性取向个体之间的健康结果差异进行了讨论。
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