Risk factors for diabetes are higher among non-heterosexual US high-school students

Abstract

Low physical activity (PA), high sedentary behavior (SB), and overweight and obesity have been shown to associate with increased Type 2 diabetes risk among adolescents. We investigated PA, SB, and overweight and obesity among Youth Risk Behavior Survey (YRBS) respondents to determine if non-heterosexual youth may be at increased diabetes risk compared to heterosexual youth. Weighted city and state YRBS data were pooled across 44 jurisdictions biennially from 2009 to 2015, resulting in a sample size of 350 673 students. Overall, 88.4% identified as heterosexual, 2.1% as gay or lesbian, 5.7% as bisexual, and 3.7% as unsure. With the exception of lesbian female students, after adjusting for age, race/ethnicity, body mass index, and survey year, all non-heterosexual youth reported significantly fewer days per week of PA compared to their sex-matched heterosexual counterparts. Similarly, compared to heterosexual female youth, bisexual and not sure female youth reported significantly more hours per day of SB. These PA and SB findings remained significant after adjustment for depressive symptoms and in-school bullying among bisexual female youth only. In fully adjusted models, lesbian students were 1.85 times more likely to be overweight and lesbian, bisexual, and not sure female youth were 1.55 to 2.07 times more likely to be obese than heterosexual female students. No significant differences in SB, overweight, or obesity were found among gay, bisexual, or unsure male youth compared to heterosexual male youth. Non-heterosexual youth may be at increased risk for developing type 2 diabetes mellitus compared to heterosexual youth. Future studies should characterize diabetes prevalence among non-heterosexual youth.

Overweight and obesity in sexual and gender minority adolescents: A systematic review

“…and M.E.B.) rated 18 studies as “good.” Three studies were rated as “fair” for the following reasons: lack of adjustment for confounding variables in statistical analyses; greater than 20% lost to follow‐up after baseline; and exposure of interest not measured prior to outcomes . Information on the quality assessment ratings for all studies is included in Table .…”

“…The preponderance of the studies (n = 16) were published between 2014 and 2018, whereas five were published between 2009 and 2013 . Of the 21 studies reviewed, 13 were cross‐sectional, six were longitudinal, and two were retrospective . Fourteen studies used nationally representative samples, six used community samples, and one used a clinical sample .…”

“…Of the 21 studies reviewed, 13 were cross‐sectional, six were longitudinal, and two were retrospective . Fourteen studies used nationally representative samples, six used community samples, and one used a clinical sample . Fifteen of the studies included cisgender sexual minority (SM) males, and 18 included cisgender SM females .…”

“…Fourteen studies used nationally representative samples, six used community samples, and one used a clinical sample . Fifteen of the studies included cisgender sexual minority (SM) males, and 18 included cisgender SM females . Four of the reviewed studies included samples of gender minority individuals (ie, samples of youth with diverse gender expressions or gender identities) .…”

“…Of the 21 studies reviewed, 15 (71%) included cisgender SM males in the sample, though one study assessed the sample in its entirety and did not conduct analyses split by gender. Therefore, results from this study were presented in the previous section but not in the current section.…”