Education and Levels of Salivary Cortisol Over the Day in US Adults

Abstract

Background - Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is hypothesized to be an important pathway linking socioeconomic position and chronic disease. Purpose - This paper tests the association between education and the diurnal rhythm of salivary control. Methods - Up to 8 measures of cortisol (mean of 5.38 per respondent) over two days were obtained from 311 respondents aged 18-70, drawn from 2001-2002 Chicago Community Adult Health Study. Multi-level models with linear splines were used to estimate waking level, rates of cortisol decline, and area-under-the-curve over the day, by categories of education. Results - Lower education (0-11 years) was associated with lower waking levels of cortisol, but not the rate of decline of cortisol, resulting in a higher area-under-the-curve for more educated respondents throughout the day. Conclusions - This study found evidence of lower cortisol exposure among individuals with less education and thus does not support the hypothesis that less education is associated with chronic over-exposure to cortisol

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