Socioeconomic and race/ethnic differences in daily salivary cortisol profiles: The Multi-Ethnic Study of Atherosclerosis

Abstract

It has often been hypothesized that stress and its biological consequences mediate the relationship between low socioeconomic status (SES) or minority status and poor cardiovascular disease outcomes. The objective of this study was to determine if daily cortisol patterns, a biomarker of the stress response, differ by race/ethnicity and socioeconomic status. Data were collected from 935 black, white and Hispanic adults age 48 to 90 years old. Salivary cortisol samples were collected six times per day over three days: at awakening, 30 minutes later, at 1000h, noon, 1800h and at bedtime. Blacks and Hispanics had lower levels of wake-up cortisol and less steep early declines, while blacks had flatter and Hispanics steeper late day declines relative to whites. Similarly the low socioeconomic status group also had lower levels of wake-up cortisol and less steep decline during the early part of the day. These patterns remained after adjustment for health behaviors and psychosocial factors. This study finds an association between salivary cortisol and race/ethnicity and SES in a multiethnic study population. Further work is needed to determine the health consequences of these differences.

Distress, circadian rhythms, immunity, and survival in presurgical breast cancer patients.

“…In a sample of pregnant women, African Americans had flatter cortisol slopes than their Hispanic counterparts (Suglia et al, 2010). Among healthy adults, African Americans had flatter slopes and lower waking cortisol levels (Hajat et al, 2010). Similar findings have been observed in African American and Hispanic adolescents (DeSantis et al, 2007).…”

“…Flattened slopes were observed in African American and Hispanic middle to older age participants, indicating the possibility that a below normal salivary cortisol response occurs due to chronic stress (Hajat et al, 2010). Additionally, among middle to older adults, African Americans had lower waking salivary cortisol and a slower decline in the afternoon (Samuel, Roth, Schwartz, Thorpe, & Glass, 2016), which is indicative of a less healthy diurnal cortisol pattern.…”

State of the Science: Salivary Biomarker Utilization for Stress Research

“…For example, the link between psychosocial stress and development of cardiovascular disease has provided a model of stress-health impact that involves the cascading responses of neuro-endocrinal and immunological responses to stress. 12,20,24,[28][29][30] The stress response is regulated by two primary neuroendocrine systems: the hypothalamus-pituitaryadrenocortical (HPA) axis and sympathetic adrenomedullary (SAM) systems. 31) Psychological stress increases HPA activity and, subsequently, elevates the level of cortisol in circulation.…”

“…12,29,33) Salivary cortisol has a diurnal peak of 13.8~48.9 nmol/l compared to blood, 190~690 nmol/l. Since the diurnal rhythm of cortisol release is well known, cortisol is usually measured in a time series, with few exceptions to reflect the awakening stress response, recovery from awakening, as well as its changes throughout the day until bedtime.…”

Effects of Soup Intake for Fourteen Days on the Mood and the Difference in Cortisol of Awakening and Evening in the Clerical Employees: An Effectiveness Study Trial

“…However, in recent years, cortisol, which is contained in saliva and easily sampled with reducing participants' burdens, is attracting more attention as a biomarker. Generally, cortisol has a circadian rhythm with high levels after awakening and a decline in levels during the day (Hajat et al, 2010). It has been also reported that individuals with a strong self-awareness of chronic stress or work stress show flatter rhythms regarding the difference in their cortisol levels between morning and evening compared with healthy individuals (Miller et al, 2007;Liao et al, 2013).…”