Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.
Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas.
Respir Care. 2022 Mar;67(3):331-338. doi: 10.4187/respcare.09258. Epub 2021 Oct 1.
Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese.
We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults ( = 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity.
About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers = 78% vs former smokers = 72%) and heterosexual (daily smokers = 68% vs former smokers = 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight = 70% or underweight = 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight = 62% or underweight = 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight = 81% vs underweight = 79%, normal weight = 78%, and obese = 72%) had the highest probabilities within lesbian/gay persons.
Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities.
尽管先前的研究已经确定了哮喘与吸烟和肥胖之间的关联，但涉及性认同的差异分析文献却很少。因此，本研究旨在检查吸烟和肥胖个体中，性认同群体之间和之内的哮喘患病率差异。
我们汇总了 2017-2019 年全国药物使用和健康调查的数据，对成年人（=128319 人）进行加权多变量逻辑回归分析和边际估计及边际图分析，以确定性认同以及吸烟和肥胖状况与哮喘患病率之间的关系。
研究人群中约有 66%报告患有哮喘。在患有哮喘的人群中，42%为肥胖者，10%为每日吸烟者，6%为双性恋者。女同性恋/男同性恋每日吸烟者（86%）或前吸烟者（75%）比双性恋者（每日吸烟者=78%，前吸烟者=72%）和异性恋者（每日吸烟者=68%，前吸烟者=65%）更有可能患有哮喘。在每个性认同亚组内，每日吸烟者（68%-86%）患有哮喘的可能性最高。肥胖的双性恋（73%）或女同性恋/男同性恋（72%）者比异性恋者（69%）更有可能患有哮喘。肥胖（73%）或超重（72%）的双性恋者（与正常体重=70%或体重不足=51%相比）和肥胖（69%）或超重（65%）的异性恋者（与正常体重=62%或体重不足=57%相比）在各自群体中患有哮喘的可能性最高，而超重者（超重=81%，体重不足=79%，正常体重=78%，肥胖=72%）在女同性恋/男同性恋者中患有哮喘的可能性最高。
吸烟和肥胖与哮喘的发生风险显著相关，性少数群体的哮喘诊断风险相对于异性恋者显著增加。这些发现为未来的纵向和实验研究提供了基础信息，以探索性和性别少数群体中哮喘风险的这些机制。
