Background

Studies have shown sexual minority women (SMW) have higher incidence of obesity, but the risk of metabolic syndrome (MetS) in SMW is unclear. We examined whether sexual orientation was associated with higher incidence of MetS and its components.

Methods

Data was extracted from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2016 examining women ages 20 to 59 years. Participants were divided into three categories: heterosexual, self-identified SMW (lesbian, bisexual) and questioning SMW. Logistic regression was used to analyze the association between MetS and sexual orientation.

Results

Of 12,755 women, 708 (5.6%) were self-identified SMW, and 365 (2.9%) were questioning SMW. Over 16 years, the proportion of self-identified SMW and questioning SMW increased. The incidence of MetS was not significantly different across the groups (Figure 1). Questioning SMW more frequently lacked health insurance compared to heterosexual women and self-identified SMW (45.5%,18%, 26.7%, respectively p<0.0001). Logistic regression demonstrated self-identified SMW had significantly higher odds of large waist circumference (OR 1.39; 95% CI 1.14-1.71) and obesity (OR 1.53; 95% CI 1.24-1.90), while questioning SMW had significantly higher odds of low high-density lipids (OR 1.5; 95% CI 1.13-1.98) compared to heterosexual women.

Conclusions

This is the largest study to date evaluating the incidence of MetS in SMW. Self-identified and questioning SMW did not have increased incidence of MetS compared to heterosexual women, but both groups had significantly increased risk of certain components of MetS. Further studies are needed to identify areas for interventions to reduce health disparities in SMW.