Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14-061, Chicago, IL, 60611, USA.
Department of Medicine, Division of Infectious Diseases and HIV Translational Research Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
J Behav Med. 2019 Dec;42(6):1073-1081. doi: 10.1007/s10865-019-00038-z. Epub 2019 Apr 9.
To date, little research has examined cardiovascular (CVD) risk among young sexual and gender minorities, a population which behavioral research has suggested may be at unique risk of poor CVD outcomes. We assessed behavioral risk factors and biomarkers of CVD risk among young sexual and gender minorities (YSGM) aged 16-29 in Chicago who are participants in the RADAR cohort (analytic N = 936). Multiplex cytokine and inflammatory biomarker assays were run on plasma from all HIV+ participants and demographically-matched HIV- participants (n = 237). Geographic data were used to assess mean C-reactive protein (CRP) level per community area of residence in Chicago. YSGM in this cohort exhibited lower rates of obesity (19.2% in RADAR vs. 35.7% in earlier studies of heterosexual youth) and comparable rates of past 30-day tobacco use (37.9 vs. 38.1%). Conversely, higher rates were observed among several other risk factors including C-reactive protein (mean = 6.9 mg/L vs. 2.1 mg/L), marijuana use (72.5 vs. 45.3%), perceived stress (mean = 15.5 vs. 14.2), and HIV (20.0 vs. < 1% nationally). Finally, we observed geographic heterogeneity in mean CRP values by community area across the Chicago region with the highest and lowest values both found in neighborhoods on the North side of the city. In sum, these analyses demonstrate that YSGM may be at increased risk of CVD beginning from an early age. Future research should assess whether sexual minority-related stressors increase long-term CVD risk and should also longitudinally study the role of multiple risk factors on CVD morbidity and mortality among YSGM.
迄今为止，针对年轻的性少数群体和性别少数群体（YSGM）的心血管（CVD）风险，研究甚少，而行为研究表明，该人群可能面临较差 CVD 结局的独特风险。我们评估了芝加哥 16-29 岁的 YSGM 的行为风险因素和 CVD 风险生物标志物，他们是 RADAR 队列（分析 N=936）的参与者。对所有 HIV+参与者和具有相似人口统计学特征的 HIV-参与者（n=237）的血浆进行了多重细胞因子和炎症生物标志物检测。使用地理数据评估了居住在芝加哥的每个社区区域的平均 C 反应蛋白（CRP）水平。该队列中的 YSGM 表现出较低的肥胖率（RADAR 中的肥胖率为 19.2%，而异性恋青年的早期研究中的肥胖率为 35.7%），且过去 30 天的烟草使用率相当（37.9%对 38.1%）。相反，在其他几个风险因素中，包括 C 反应蛋白（平均值为 6.9mg/L 对 2.1mg/L）、大麻使用（72.5%对 45.3%）、感知压力（平均值为 15.5 对 14.2）和 HIV（20.0%对全国范围内的<1%），报告率更高。最后，我们观察到芝加哥地区各个社区区域的 CRP 平均值存在地理异质性，城市北侧的社区区域 CRP 平均值最高，最低值也在城市北侧的社区区域。总之，这些分析表明，YSGM 可能从早期开始就面临 CVD 风险增加的风险。未来的研究应评估性少数群体相关压力源是否会增加长期 CVD 风险，还应纵向研究多个危险因素在 YSGM 中的 CVD 发病率和死亡率中的作用。
