Columbia University School of Nursing, New York, New York.
J Womens Health (Larchmt). 2019 Sep;28(9):1200-1217. doi: 10.1089/jwh.2018.7381. Epub 2019 May 17.
Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. Next, multiple logistic regression was used to examine the associations of different forms of trauma throughout the life course (childhood, adulthood, and lifetime), with psychosocial and behavioral risk factors and self-reported cardiometabolic risk (obesity, hypertension, and diabetes) in SMW adjusted for relevant covariates. A total of 547 participants were included. Older age was associated with higher rates of childhood and adulthood trauma. SMW of color reported higher rates of childhood trauma than white participants. Higher education was associated with lower rates of adulthood trauma. All forms of trauma were associated with probable diagnosis of post-traumatic stress disorder and lower perceived social support. Adult trauma was associated with anxiety, whereas childhood and lifetime trauma were associated with higher odds of depression. No significant associations between forms of trauma and behavioral risk factors were noted, except that childhood trauma was associated with higher odds of past-3-month overeating. Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.
性少数群体女性（SMW；如女同性恋、双性恋者和主要是女同性恋者）表现出过多的心血管代谢风险，但导致该人群心血管代谢风险的因素知之甚少。创伤暴露被认为是 SMW 心血管代谢风险的一个因素。对芝加哥女性健康和生活经历研究的第 3 波数据进行了分析。使用多项逻辑回归来检查创伤的相关性。接下来，使用多项逻辑回归来检查整个生命过程（儿童期、成年期和终生）中不同形式的创伤与心理社会和行为风险因素以及自我报告的心血管代谢风险（肥胖、高血压和糖尿病）之间的关联，调整了相关协变量。共有 547 名参与者被纳入。年龄较大与儿童期和成年期创伤发生率较高有关。有色人种的 SMW 比白人参与者报告的儿童期创伤发生率更高。较高的教育程度与成年期创伤发生率较低有关。所有形式的创伤都与创伤后应激障碍的可能诊断和较低的感知社会支持有关。成年创伤与焦虑有关，而儿童期和终生创伤与抑郁的可能性更高有关。除了儿童期创伤与过去 3 个月暴饮暴食的可能性更高有关外，没有发现各种形式的创伤与行为风险因素之间存在显著关联。检查创伤与心血管代谢风险之间关联的逻辑回归模型显示，儿童期创伤是糖尿病的独立危险因素。成年期和终生创伤与肥胖和高血压显著相关。创伤是 SMW 心血管代谢风险的一个独立危险因素。这些发现表明，临床医生应在 SMW 中筛查创伤作为心血管风险因素，特别关注最易受伤害的 SMW。
