Ethnic differences in diurnal cortisol profiles in healthy adults: A meta‐analysis

Abstract

Purpose. Cortisol is a well-known biomarker of the physiological stress system; atypical cortisol patterns have been linked to many psychological and physiological illnesses. Previous studies have found vast health disparities among ethnic groups; however, studies examining the relationship between cortisol and ethnicity have found mixed results. This meta-analysis investigated whether there are differences in diurnal cortisol outcomes among ethnic groups, while considering the moderating roles of various individual factors and methodological approaches.Methods. Search phrases were entered into MEDLINE, PsycINFO, EMBASE, Cochrane Library, CINAHL, Scopus, and Web of Science. Effect sizes were extracted for ten diurnal cortisol outcomes, including waking, 30 min after waking, cortisol awakening response, slope, area under the curve, urinary twenty-four-hour secretion, total cortisol output, and midday, evening, and bedtime concentrations, for eight ethnic group comparisons, including Asians, Blacks, Hispanics, Indigenous people, Whites, Minority and Majority groups, and Multiethnic groups. Moderator analyses, including variables such as gender, age, and number of cortisol collection time points, were conducted.Results. There were significant ethnic differences in diurnal cortisol profiles, including cortisol awakening responses, with more robust differences in ethnic comparisons that included White participants. Differences in diurnal cortisol profiles were also moderated by gender, mean age, and sample size.Conclusions. This meta-analysis supports the notion that ethnic groups exhibit distinct diurnal cortisol profiles, which, according to the biopsychosocial model of health, may be a result of unique sociocultural experiences. The limitations of this meta-analysis and future directions for stress research with various ethnic groups are discussed. Statement of contributionWhat is already known on this subject?Studies have found vast health disparities among ethnic groups. Psychological and physiological illnesses and atypical diurnal cortisol profiles are strongly correlated.Studies have examined the relationship between diurnal cortisol rhythms and ethnicity, but findings are mixed.

LC-MS/MS-based reference intervals for hair cortisol in healthy children

“…Several explanations have been offered to explain this effect (Abell et al, 2016). First, certain ethnic groups are more likely to be exposed to biopsychosocial stressors (Boileau et al, 2019). Second, there are differences in the hair textures of different ethnic groups, and some textures may lead to more incorporation of cortisol into hair (Wosu et al, 2015).…”

Cortisol response to psychological stress in patients with schizophrenia in the Chinese population

“…Considering that previous studies were conducted in the Western parts of the world, some differences may have been due to our participants being from a Han Chinese population. Many studies revealed racial differences in cortisol levels [28][29][30][31] , one study also found that people of different ethnicity have different responses to psychological support under pressure [32] . All these suggest that cortisol and stress-related research may have ethnic differences.…”

Cortisol Response to Psychological Stress in Patients with Schizophrenia in The Chinese Population

“…Considering that previous studies were conducted in the Western parts of the world, some differences may have been due to our participants being from a Han Chinese population. Many studies revealed racial differences in cortisol levels [27][28][29][30] , one study also found that people of different ethnicity have different responses to psychological support under pressure [31] . All these suggest that cortisol and stress-related research may have ethnic differences.…”