Sistematski pregled i meta-analiza epidemiologije dijabetes melitusa, kardiovaskularnih i respiratornih stanja kod žena seksualnih manjina.
BMJ open
Sažetak istraživanja
Cilj Žene iz seksualnih manjina (SMW) imaju veće faktore rizika od hroničnih bolesti od heteroseksualnih kolega. Međutim, bilo je nejasno da li se ovi rizici prevode u veće stope fizičkog stanja. Ovaj sistematski pregled procjenjuje kardiovaskularne bolesti (KVB), hipertenziju, respiratorne bolesti i dijabetes melitus u SMW.
Metode Protokol je registrovan u Prospero bazi podataka (CRD42016050299). Uključene su studije koje izvještavaju o mortalitetu, učestalosti ili prevalenci gore navedenih stanja u SMW u poređenju sa heteroseksualnim ženama. Baze podataka (platforme) koje su pretraživane od 2010. do decembra 2016. bile su Medline (Ovid), Embase (Elsevier), Kumulativni indeks sestrinske i srodne zdravstvene literature (Elsevier), PsycINFO (Ovid), Social Policy and Practice (Ovid), Cochrane CENTRAL (Cochrane CENTRAL of Science), We Cib CENTRAL of Science Sažeci (Ovidije). Pojmovi za pretragu su uključeni termini i tekstualne riječi iz naslova medicinskih predmeta (MeSH). Provedene su opsežne dodatne pretrage u stručnim akademskim časopisima i web stranicama. Dva recenzenta su provjerila podobnost studije. Jedan je nezavisno izdvojio podatke i ocenio kvalitet, proverio drugi recenzent, a nesuglasice su rešene kroz diskusiju. Za procjenu rizika od pristrasnosti korištena je kohortna kontrolna lista Programa vještina kritične procjene. Meta-analiza je sprovedena u kojoj je više od četiri studije prijavilo iste ishode, uz softver Comprehensive Meta-Analysis, koristeći prilagođene OR (AOR) i modele slučajnih efekata. Heterogenost je procijenjena I 2 testom. Identifikovani rezultati su 23 103 citata, pregledana 692 puna teksta i uključeno 16 studija (u 18 radova). Jedna prijavljena smrtnost (iz Danske), nijedna incidencija i 15 prevalencija (14 SAD, 1 Australija). Istopolne vanbračne žene su imale višu stopu mortaliteta u poređenju sa ženama koje žive u suprotnom spolu kod KVB (HR=1,37 (95% CI 1,22 do 1,54)) i respiratornih bolesti (HR=2,10 (95% CI 1,74 do 2,53)). AOR meta-analize sedam studija su pokazale veće stope astme kod lezbejki (OR=1,44 (95% CI 1,27 do 1,64), I 2 =0%) i biseksualnih žena (OR=1,64 (95% CI 1,41 do 1,89), I 2 =0%), ali bez razlika u studijama o dijabetesu 555 za hipermeltus. (7 studija).
Zaključci Ove nove zdravstvene procjene zahtijevaju daljnje potvrdne epidemiološke studije i istraživanje potencijalnih okolišnih, hormonalnih, fizioloških, psiholoških ili genetskih uzroka. Ovo bi bilo podržano rutinskim prikupljanjem mjera seksualnog identiteta u epidemiološkim istraživanjima na nivou stanovništva.
Prikaži originalni naslov i sažetak na engleskom
Systematic review and meta-analysis of diabetes mellitus, cardiovascular and respiratory condition epidemiology in sexual minority women.
Objective Sexual minority women (SMW) experience higher chronic disease risk factors than heterosexual counterparts. However, it was unclear if these risks translate into higher physical condition rates. This systematic review evaluates cardiovascular disease (CVD), hypertension, respiratory disease and diabetes mellitus in SMW.
Methods A protocol was registered with the Prospero database (CRD42016050299). Included were studies reporting mortality, incidence or prevalence of the above-listed conditions in SMW compared with heterosexual women. Databases (platforms) searched from 2010 to December 2016 were Medline (Ovid), Embase (Elsevier), Cumulative Index to Nursing and Allied Health Literature (Elsevier), PsycINFO (Ovid), Social Policy and Practice (Ovid), Cochrane CENTRAL (Cochrane Library), Science Citation Index (Web of Science), and CAB Abstracts (Ovid). Search terms included Medical Subject Heading (MeSH) terms and text words. Extensive additional searches were conducted in specialist academic journals and websites. Two reviewers checked study eligibility. One independently extracted data and assessed quality, checked by a second reviewer, with disagreements resolved through discussion. The Critical Appraisal Skills Programme cohort checklist was used to assess risk of bias. Meta-analysis was conducted where more than four studies reported the same outcomes, with Comprehensive Meta-Analysis software, using adjusted ORs (AORs) and random-effects models. Heterogeneity was assessed using I 2 test.
Results Identified were 23 103 citations, 692 full texts screened and 16 studies included (in 18 papers). One reported mortality (from Denmark), none incidence and 15 prevalence (14 USA, 1 Australia). Same-sex cohabiting women had higher mortality rates compared with opposite-sex cohabiting women in CVD (HR=1.37 (95% CI 1.22 to 1.54)) and respiratory disease (HR=2.10 (95% CI 1.74 to 2.53)). AOR meta-analyses of seven studies showed higher asthma rates in lesbians (OR=1.44 (95% CI 1.27 to 1.64), I 2 =0%) and bisexual women (OR=1.64 (95% CI 1.41 to 1.89), I 2 =0%) but no differences for CVD (5 studies), hypertension (5 studies) or diabetes mellitus (7 studies).
Conclusions These new health estimates require further confirmatory epidemiological studies, and investigation into potential environmental, hormonal, physiological, psychological or genetic causes. This would be supported by routine collection of sexual identity measures in population-level epidemiological surveys.
Izvorni podaci
- DOI
- 10.1136/bmjopen-2017-020776
- PMID
- 29666136
- PMCID
- PMC5905763
- Provjereno
- 2026-07-26
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