Gender-specific Odds Ratios Research Articles

Sexual minority substance use disparities: Bisexual women at elevated risk relative to other sexual minority groups

BackgroundPrior studies characterizing sexual minority substance use disparities have primarily compared lesbian/gay and bisexual individuals, respectively or in combination, to heterosexual individuals. In light of emerging evidence that bisexual individuals may have particularly elevated substance use risk, we examine differences in recent substance use between bisexual and lesbian/gay individuals using national survey data. MethodsData on 126,463 adults (including 8241 LGB adults) were from the 2015–2017 National Survey on Drug Use and Health. Substance use outcomes included binge drinking, cigarette smoking, cigar smoking, marijuana use, illicit drug use, opioid misuse, alcohol use disorder, nicotine dependence, and substance use disorder. Logistic regression was used to estimate sexual identity- and gender-specific odds ratios, controlling for demographic characteristics. Of particular interest were estimates comparing bisexual and lesbian/gay individuals of the same gender. ResultsBoth male and female sexual minority adults had significantly elevated rates of substance use compared to heterosexual adults. Furthermore, relative to lesbian/gay women, bisexual women had significantly elevated odds of binge drinking (aOR = 1.29), marijuana use (aOR = 1.42), illicit drug use (aOR = 1.55), opioid misuse (aOR = 1.53), and alcohol use disorder (aOR = 1.48). Relative to gay men, bisexual men had significantly elevated cigar use (aOR = 1.64). ConclusionsBisexual women were at significantly greater risk for multiple substance use behaviors relative to lesbian/gay women. We did not observe any substance use behaviors for which bisexual individuals had significantly lower risk than their lesbian/gay peers. These disparities may be explained, in part, by unique risk factors for substance use experienced by bisexual individuals, particularly bisexual women.

Living Alone or With Others and Depressive Symptoms, and Effect Modification by Residential Social Cohesion Among Older Adults in Japan: The JAGES Longitudinal Study.

BackgroundThere is little longitudinal evidence on the impact of specific living arrangements (ie, who individuals live with) on mental health among older adults, and no studies have examined the modifying effect of residential social cohesion level on this association. We aimed to examine the association between living arrangements and depressive symptoms and whether this association varies with residential neighborhood social cohesion level among 19,656 men and 22,513 women aged 65 years and older in Japan.MethodsWe analyzed the association between baseline living arrangements in 2010 and depressive symptoms in 2013. We calculated gender-specific odds ratios (ORs) of living arrangements for depressive symptoms using a logistic regression and conducted subgroup analyses by neighborhood social cohesion level.ResultsAmong men (but not women), living alone (OR 1.43; 95% confidence intervals [CI], 1.18–1.73) and living with spouse and parent (OR 1.47, 95% CI, 1.09–1.98) were associated with increased odds of depressive symptoms compared with living with a spouse only. Living with spouse and child was a risk for men in the young age group but a protective factor for women. We also identified that the negative impact of living arrangements on depressive symptoms was attenuated in neighborhoods with higher levels of social cohesion.ConclusionsLiving arrangements are associated with risk of depressive symptoms among men and women; these associations differ by gender and neighborhood social cohesion level. Our results suggest the need to pay more attention to whether individuals live alone, as well as who individuals live with, to prevent depressive symptoms among older adults.

Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity

BackgroundSexual minorities (SMs) experience elevated rates of substance use behaviors and disorders relative to heterosexuals; minority stress is theorized to contribute to these disparities. As SMs are not a homogenous group, analyses that aggregate SMs across sexual identity, age, or gender obscure important variation among this population. To date, age- and gender-specific disparities have not been rigorously examined using a large national sample. MethodsUsing data on 67,354 adults (ages 18–49) from the 2015 and 2016 National Survey of Drug Use and Health we examined age- and gender-specific disparities in smoking, heavy episodic drinking, marijuana use, illicit drug use, and alcohol/substance use disorder. Age groups were ages 18–25, 26–34, and 35–49. Using logistic regression, we estimated age- and gender-specific odds ratios for gay/lesbian and bisexual individuals, relative to heterosexuals; analyses adjusted for demographic characteristics. ResultsBisexual women had significantly elevated odds of all outcomes at all ages, relative to heterosexual women. Gay/lesbian individuals had significantly elevated odds for nearly all outcomes compared to same-gender heterosexuals at ages 18–25, but not consistently at older ages. For bisexual men, significant disparities compared to heterosexual men were only observed at ages 35–49 for marijuana use and alcohol/substance use disorder. ConclusionsWe found notable within-group differences regarding SM disparities. While disparities were most pronounced in young adulthood for gay/lesbian individuals and mid-adulthood for bisexual men, bisexual women uniquely experienced disparities across all ages. Minority stress experiences may vary with respect to gender, age/cohort, and sexual identity, resulting in differential risk for substance use.

Gender-dependent associations between occupational status and untreated caries in Japanese adults.

The aim of this study was to examine whether the presence of untreated caries is different across occupational status among Japanese adults. This was a cross-sectional survey of 1,342 individuals (990 males and 352 females) aged 40–64 yr who underwent medical and dental checkups at a healthcare center in 2011. Oral examination was performed by a dentist and the presence of untreated caries was defined as having at least one untreated decayed tooth. Data regarding current occupational status were obtained using a self-administered questionnaire; the participants were classified into five groups: professionals and managers, clerical and related workers, service and salespersons, agricultural, forestry, and fishery workers, and homemakers and unemployed. Gender-specific odds ratios (ORs) and 95% confidence intervals (CIs) of occupational status for the presence of untreated caries were estimated using logistic regression. After adjusting for potential confounders, female professionals and managers (OR=3.51, 95% CI=1.04–11.87) and service and salespersons (OR=5.29, 95% CI=1.39–20.11) had greater risks of the presence of untreated caries than female homemakers and unemployed. However, this tendency was not observed among males. In conclusion, there was a significant difference in risk of the presence of untreated caries by occupational status among females.

Suppressing emotion and engaging with complaining customers at work related to experience of depression and anxiety symptoms: a nationwide cross-sectional study.

Our aim was to investigate the relationship between suppressing emotion and engaging with complaining customers at work and experience of depression and anxiety symptoms. We used nationally representative data from the Korean Working Condition Survey with 15,669 paid customer service workers. Job characteristics of “Engaging with Complaints”, “Suppressing Emotion”, experience of depression and anxiety symptoms were measured by self-reported questionnaires. Gender specific odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using multivariate logistic regression after controlling for age, income, education level, job satisfaction, and working hours per week. The results showed that people who were ‘Always Engaging with Complaints’ (OR: 3.81, 95% CI: 1.83–7.96 for male, OR: 3.98, 95% CI: 2.07–7.66 for female) and ‘Always Suppressing Emotion’ (OR: 2.33, 95% CI: 1.33–4.08 for male, OR: 2.83, 95% CI: 1.67–4.77 for female) were more likely to experience depression and anxiety symptoms compared to those ‘Rarely Engaging with Complaints’ and ‘Rarely Suppressing Emotion’, respectively. Additionally, there was an interactive relationship between those job characteristics. Our nationwide study demonstrates that mental health problems are incrementally related to how much service workers must engage with complaining customers and suppressing emotion at work.

Asymptomatic hyperuricemia is a strong risk factor for resistant hypertension in elderly subjects from general population.

In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study. RH was defined as the failure to maintain blood pressure values below 140mmHg (systolic) and 90mmHg (diastolic) despite therapeutic interventions that include appropriate lifestyle measures plus adherence to treatment with full doses of at least three antihypertensive drugs, including a diuretic. RH was confirmed using 24-h ambulatory blood pressure measurement. Hyperuricemic was defined as the subjects having SUA ≥6.8mg/dl or taking uricosuric drugs. Gender-specific odds ratio (OR) for RH was calculated by logistic regression analysis. The prevalence of RH was 5.7% in the cohort and was higher in women (8.3%) than in men (3.0%, p<0.05). Independent of chronic kidney disease (OR 3.89, 95% confidence interval 1.49-10.1), hyperuricemia predicted resistant hypertension in women (odds ratio 3.11, 95% confidence intervals 1.06-9.1, p=0.03) but not in men. In elderly women from the general population, an SUA value of ≥6.8mg/dl triples the risk of RH. SUA assessment should be recommended to better define the pattern of risk associated with RH.

The effect of gender on aminoglycoside-associated nephrotoxicity .

The kidney disease improving global outcomes (KDIGO) clinical practice guidelines for acute kidney injury (AKI) has endorsed the widely held belief that female gender is a risk factor for aminoglycoside-associated nephrotoxicity (AAN). In contrast, female gender is protective in animal models. In light of this dichotomy, we sought to explore this relationship in greater detail. We performed a meta-analysis of studies published between 1978 and 2015 which examined aminoglycoside nephrotoxicity and provided gender-specific data. 24 studies were identified that provided univariate gender-specific data. The incidence of AAN did not differ between the sexes (odds ratio (OR) for females vs. males 1.00 (0.81, 1.22), p=0.97, n=5,980). Twelve studies utilized logistic regression analysis with gender as a covariate. Meta-analysis of the 5 studies that utilized multivariate analysis and reported gender-specific OR found no effect of gender on the risk of AAN (OR 0.99 (0.58, 1.69), p=0.96, n=2,994). Similarly, gender was not an independent risk factor for AAN in the remaining 7 studies that utilized multivariate analysis with gender as a covariate but failed to report gender-specific OR (n=1,636). Our meta-analysis contradicts the generally held consensus that female gender is an independent risk factor for the development of AAN. Our findings may have much wider implications insofar as AAN cannot be used as an example to support the conclusion of the KDIGO Clinical Practice Guidelines that female gender is an independent risk factor for AKI. .

Early Father Involvement and Subsequent Child Behaviour at Ages 3, 5 and 7 Years: Prospective Analysis of the UK Millennium Cohort Study.

ObjectiveFathers are increasingly involved in care of their babies and young children. We assessed the association of resident fathers’ involvement with subsequent behaviour of their children, examining boys and girls separately.MethodsWe used longitudinal data from the UK Millennium Cohort Study for children born in 2000–2001, divided into three separate analysis periods: ages 9 months to 3 years, 3 to 5 years, and 5 to 7 years. By exploratory factor analysis of self-reported attitudes and engagement in caring activities, we derived composite measures of various types of father involvement at 9 months, 3 and 5 years. Where possible we created equivalent measures of mother involvement. Child behaviour was assessed by the Strengths and Difficulties Questionnaire (SDQ), which was completed by the mother when the child was aged 3, 5 and 7 years. We estimated gender-specific odds ratios for behaviour problems per quintile of father involvement, using separate logistic regression models for boys and girls in each analysis period. We controlled for a wide range of potential confounders: characteristics of the child (temperament and development at 9 months, and illness and exact age at outcome), equivalent mother involvement where appropriate, and factors related to socioeconomic status, household change, and parental well-being, where statistically significant.ResultsPaternal positive parenting beliefs at age 9 months and increased frequency of creative play at age 5 years were significantly associated with lower risk of subsequent behaviour problems (SDQ total difficulties) in both boys and girls (p<0.05), odds ratios ranging between 0.81 and 0.89 per quintile of involvement. No associations were observed for other composite measures of caring activity by the father at 9 months, 3 years or 5 years.ConclusionQuality of parenting, rather than the division of routine care between parents, was associated with child behavioural outcomes.

Does High Emotional Demand with Low Job Control Relate to Suicidal Ideation among Service and Sales Workers in Korea?

We examined the relationship of high emotional demands and low job control to suicidal ideation among service and sales workers in Korea. A total of 1,995 service and sales workers participated in this study. Suicidal ideation and level of emotional demand and job control were assessed by self-reported questionnaire in 4th Korean National Health and Nutrition Examination Survey. Gender-specific odds ratio (OR) and 95% confidence intervals (95% CI) for suicidal ideation were calculated using logistic regression analysis. The results show that workers who suffered from high emotional demands (OR, 2.07; 95% CI, 1.24-3.45 in men, OR, 1.97; 95% CI, 1.42-2.75 in women) or low job control (OR, 1.96; 95% CI, 1.42-2.75 in men, OR, 1.33; 95% CI, 0.91-1.93 in women) were more likely to experience suicidal ideation after controlling for age, household income, and employment characteristics. The interaction model of emotional demands and job control revealed that workers with high emotional demands and high job control (OR, 1.93; 95% CI, 1.08-3.45 in men, OR, 1.60; 95% CI,1.06-2.42 in women) and high emotional demands and low job control (OR; 4.60, 95% CI;1.88-11.29 in men, OR; 2.78, 95% CI;1.64-4.44 in women) had a higher risk for suicidal ideation compared to those with low emotional demands and high job control after controlling for age, household income, employment characteristics, smoking, alcohol drinking and physical activity habit. These results suggest that high emotional demands in both genders and low job control in men might play a crucial role in developing suicidal ideation among sales and service workers in Korea.

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Objective: It's well established that resistant hypertension (RH) is associated with a longer history of hypertension, obesity and other accompanying cardiovascular (CV) risk factors, such as diabetes, left ventricular hypertrophy (LVH), albuminuria and chronic renal dysfunction (CKD). On the contrary little is known about the role of serum uric acid (SUA) as risk factor for RH. Design and method: The Risk Of Vascular complications: Impact of Genetics in Old people (ROVIGO) study is a cross-sectional, population-based study performed in 580 elderly subjects aged >= 65 years, representative of general population living in Rovigo, a town of Veneto region, in the North-Eastern of Italy. According to 2013 ESH/ESC guidelines RH was defined as failure to lower clinic systolic and diastolic blood pressure (BP) values <140/90 mmHg despite a therapeutic strategy including appropriate lifestyle measures plus the adherence to treatment with full doses of at least 3 antihypertensive drugs, including a diuretic. We defines hyper-uricemic subjects, those having SUA level >= 6.5 mg/dl, this latter a cut-off value for which in physiologic conditions SUA precipitation is observed. LVH was diagnosed by 12-leads electrocardiogram using the Sokolow-Lion index criterion and CKD was defined by an eGFR<60 ml/min/1.73m2 calculated with the MDRD formula. Gender specific odds ratio (OR) and 95% confidence intervals (CI 95%) for RH were calculated for independent variables by binary logistic regression analysis. Results: The prevalence of RH was 5.7% and it was not different in men than in women (6.3% and 5.2%, NS, respectively). Independently of age, history oh hypertension, anti-hypertensive treatment, diabetes, obesity (i.e. BMI>30 kg/m2), LVH, albuminuria, and CKD, hyper-uricemia predicts RH in women (OR 4.4, CI95% 1.24–15.7, p = 0,022) but not in men (OR 1.46, CI95% 0.51 -4.21, p = 0.47). Conclusions: In elderly women from general population a SUA > = 6.5 mg/dl 4-fold increase the risk of RH. To better define the REAL burden of RH, SUA assessment is recommended. We speculate that lowering SUA levels may reduce the prevalence of RH. However to confirm this hypothesis interventional clinical trials are needed.

Hyperhomocysteinemia is an independent predictor of sub-clinical carotid vascular damage in subjects with grade-1 hypertension

Although the role of homocysteinemia (Hcy) as a coronary risk factor (RF) has been scaled down, hyper-Hcy and carotid vascular damage (CVD) are still considered as RFs for cerebrovascular events. In 276 grade-1 hypertensives (160 men and 116 women aged 59.6 ± 15.0 years) without known cardiovascular disease and having hyper-Hcy (≥15 μM/L), subclinical CVD was evaluated by ultrasonographic carotid-wall intima media thickness (IMT). Hcy was divided into quartiles and C667→T polymorphism codifying for methylenetetrahydrofolate reductase (MTHFR) was determined. According to the genotype, subjects were divided into CC (wild), CT (heterozygote) and TT (homozygous mutation). Differences between continuous variables were evaluated by analysis of variance, while gender specific odds ratio (OR) and 95 % confidence intervals (CI) of CVD (IMT >0.9 mm or plaque) were calculated by multivariate logistic regression analysis. Blood pressure (BP) values were not different across the quartiles of Hcy. In 46.4 % of cases, sub-clinical CVD was found, with a prevalence increasingly distributed in the quartiles of Hcy (31.9, 42, 52.2, 59.4 %, p < 0.001). Prevalence of TT allele of the MTHFR genotype was also significantly distributed in the quartiles of Hcy (13.6, 12.3, 23.5 and 50.6 %, p < 0.0001), whereas no relationship was found between genotype and CVD. The last quartile of Hcy predicted CVD (OR 1.32, CI 1.12-2.2, p = 0.02) independent of age (OR 1.23, CI 1.002-1.56, p = 0.0001), systolic BP (OR 1.52, CI 1.24-2.10), diabetes (OR 2.11, CI 1:32-2.88, p = 0.01) and smoking (OR 1.45, CI 1.14-1.98, p = 0.04). Adding gender did not modify the model. In hypertensives, Hcy values >36.5 μM/L independently predict CVD and in those who are also diabetic and smokers, Hcy assessment without MTHFR genotype should be recommended to obtain a better stratification of global cerebrovascular risk.

Renal scintigraphy predicts global cardiovascular risk in hypertensive subjects with normal serum creatinine levels

Background. This cross-sectional study investigates the role of renal scintigraphy on cardiovascular (CV) risk stratification in normoalbuminuric, non-diabetic hypertensive subjects (HTs) free from CV disease and renal dysfunction. Methods. In 200 HTs aged 55–75 years, glomerular filtration rate (GFR) was measured by technetium-99m-diethylene triamine pentacetic acid clearance during renal scintigraphy. Stage III chronic kidney disease (CKD) was defined as GFR < 60 ml/min/1.73 m2. For comparing the impact of different methods for CKD diagnosis on CV risk stratification, CKD was also considered as GFR estimated by the Modification of Diet in Renal Disease (MDRD) equation and Cockcroft–Gault's formula. Target organ damage (TOD) was assessed by echocardiography and carotid ultrasonography. Gender-specific odds ratio (OR) with 95% confidence intervals for CKD were derived from a multiple stepwise logistic regression analysis. Global CV risk was stratified according to routine examinations, TOD and CKD. Results. In 38% of cases, an unknown stage III CKD was found. Independent of age, CKD was predicted by history of hypertension (OR = 1.69, p = 0.0001), albuminuria (OR = 1.25, p = 0.0001), smoking (OR = 1.85, p = 0.028) and pulse pressure (OR = 1.21, p = 0.019) in men only. Men had an increased risk of CKD (OR = 2.62, p = 0.002) in comparison with women. Prevalence of TOD was significantly higher only in HTs having CKD diagnosed by renal scintigraphy; TOD and CKD assessment added to classic risk factors modified the CV risk stratification from low-moderate to high and very high. Conclusions. Renal scintigraphy is an important aid in risk stratification and should be performed in HTs aged ≥ 55 years. Pulse pressure was the main blood pressure component that predicted the risk of stage III CKD.

The Impact of Gender and General Risk Factors on the Occurrence of Atherosclerotic Vascular Disease in Non-insulin-dependent Diabetes Mellitus

While it is generally accepted that non-insulin-dependent diabetes mellitus (NIDDM) increases atherosclerotic risk, controversy remains as to whether this effect is greater for women than men (thus reducing the usual gender differential). Furthermore, it is unclear to what extent changes in general risk factors may account for this increased risk. The literature was reviewed with meta-analyses. Gender specific overall relative risks with 95% confidence intervals for coronary heart disease (CHD) mortality (ICD codes 410-414) were calculated. Similarly, overall gender specific odds ratios for prevalent myocardial infarction (MI) are presented. Data are generated from both fixed effects and random effects models. Frequency counts of studies showing specific cardiovascular disease (CVD) risk factor effects in diabetes are given as is the number of studies showing diabetes to be an independent risk factor. The overall relative risk (the ratio of men to women) for CHD mortality in diabetes was 1.46 (1.21-1.75) and 2.29 (2.05-2.55) in nondiabetes suggesting that the gender differential is reduced in diabetes. However, heterogeneity was high (P < 0.001). Exclusion of studies that were exclusively in elderly subjects eliminated heterogeneity (P > 0.05), but retained a separation of the confidence intervals. Overall odds ratios (men:women) show no suggestion of a diabetes effect on the gender difference for prevalent MI, 1.77 (diabetes) and 1.79 (no diabetes). The effects of six general CVD risk factors were unclear, although the largest study showed a clear effect of cholesterol, smoking, and blood pressure. All 10 studies in women report diabetes to be an independent risk factor as do 8 out of 12 studies in men. NIDDM reduces the gender differential in CHD mortality, but not for prevalent MI (or other end points). Although the effect of specific CVD risk factors is inconsistent across studies, this is likely to reflect limited sample size and power. The major three risk factors, cholesterol, blood pressure, and smoking, probably operate in NIDDM but do not fully explain the increased risk of CVD in NIDDM.