Arslanian-Engoren Cynthia, Everett Bethany G, McCabe Sean Esteban, Evans-Polce Rebecca, Hughes Tonda L, Boyd Carol J, Veliz Philip T
Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
Division of Family Planning, Department of Sociology, University of Utah, Salt Lake City, Utah, USA.
Ann LGBTQ Public Popul Health. 2024 Dec;5(4):294-317. doi: 10.1891/lgbtq-2024-0003.
Few studies have compared cardiovascular disease (CVD) risk factors in sexual minority and heterosexual adults. It remains unclear whether changes in sexual identity over time are associated with increased CVD risk. The purposes of this longitudinal study were to: 1) compare sex differences in CVD risk factors across sexual identity subgroups, 2) examine CVD risk factors based on changes in sexual identity, and 3) to examine sex-stratified variations in CVD risk factors. Analyses of the Population Assessment of Tobacco and Health (PATH) study data assessed the longitudinal association of changes in sexual identity with self-reported CVD risk factors (alcohol misuse, cigarette smoking, sedentary behavior, high cholesterol, high blood pressure, obesity). Based on changes in sexual identity between baseline/wave 1 and wave 5, 91.7% (n = 15884) of the sample were heterosexual-stable, 1.1% (n = 265) were gay/lesbian-stable, and 0.8% (n = 265) bisexual-stable. Less than two percent (1.5%; n = 376) indicated one heterosexual (sexual majority)-to-sexual minority change, 1.4% (n =299) reported one sexual minority-to-heterosexual change, 0.7% (n= 202), one or more sexual minority-to-sexual minority changes, 1.4% (n = 345) heterosexual-to-sexual minority-to-heterosexual change, and 1.3% (n = 365) indicated two or more changes with no distinct pattern. Among women, two or more changes in sexual identity with no distinct pattern were associated with increased odds of past 30-day alcohol misuse compared to heterosexual-stable women. Associations between changes in sexual identity and alcohol misuse among women suggest the need for greater screening among healthcare providers who work with this population.
很少有研究比较过性少数群体和异性恋成年人的心血管疾病（CVD）风险因素。性取向随时间的变化是否与心血管疾病风险增加相关仍不清楚。这项纵向研究的目的是：1）比较不同性取向亚组中心血管疾病风险因素的性别差异；2）根据性取向的变化检查心血管疾病风险因素；3）检查心血管疾病风险因素的性别分层差异。对烟草与健康人口评估（PATH）研究数据的分析评估了性取向变化与自我报告的心血管疾病风险因素（酒精滥用、吸烟、久坐行为、高胆固醇、高血压、肥胖）之间的纵向关联。根据基线/第1波和第5波之间的性取向变化，样本中91.7%（n = 15884）为异性恋稳定型，1.1%（n = 265）为同性恋/女同性恋稳定型，0.8%（n = 265）为双性恋稳定型。不到2%（1.5%；n = 376）表示有一次从异性恋（性多数群体）到性少数群体的转变，1.4%（n = 299）报告有一次从性少数群体到异性恋的转变，0.7%（n = 202）有一次或多次从性少数群体到性少数群体的转变，1.4%（n = 345）从异性恋到性少数群体再到异性恋的转变，1.3%（n = 365）表示有两次或更多次无明显模式的转变。在女性中，与异性恋稳定型女性相比，有两次或更多次无明显模式的性取向变化与过去30天酒精滥用几率增加相关。女性中性取向变化与酒精滥用之间的关联表明，与该人群打交道的医疗保健提供者需要加强筛查。
