Measures of Social Position and Cortisol Secretion in an Aging Population: Findings From the Whitehall II Study
Measures of Social Position and Cortisol Secretion in an Aging Population: Findings From the Whitehall II Study
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DOI：
10.1097/psy.0b013e3181c85712
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发表时间：
2010-01-01
影响因子：
3.3
通讯作者：
Marmot, Michael G.
中科院分区：
文献类型：
--
作者：
Kumari, Meena;Badrick, Ellena;Marmot, Michael G.
目的：探讨与劳动人群社会地位低下相关的下丘脑-垂体-肾上腺（HPA）轴失调是否也存在于老年人群中。方法：本研究考察了社会地位的几个指标与皮质醇分泌的两种测量之间的关系，皮质醇分泌是HPA轴的产物。我们检查了皮质醇唤醒反应（CAR），以及皮质醇分泌在一天中下降的斜率。在Whitehall 11研究第7期（2002-2004）的3992名参与者中，我们研究了这种关联是否由行为、社会心理和生物因素介导，这些参与者每天提供6份唾液皮质醇样本。结果：在这个年龄较大的队列中（平均年龄61岁，范围50-74岁），最低的社会地位（通过当前或以前的职业等级和财富来评估）与皮质醇分泌下降的平缓斜率相关。例如，在一天的过程中，最低就业等级的男性皮质醇下降了0.125 (nmol/L/h)，这比高等级的男性（-0.129 nmol/L/h）的斜率要浅。不同职业等级的男性，而非女性的斜率差异具有统计学意义（p = 0.003）。坡度的差异主要是由健康状况不佳和睡眠习惯造成的，尽管经济上的不安全感也起到了一定作用。CAR或其他衡量社会地位的指标没有明显的影响。结论：在男性中，较差的健康和睡眠行为（主要是吸烟和睡眠时间短）以及经济不安全感介导了职业地位和财富对皮质醇分泌的影响。
Objective: To examine whether dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis associated with disadvantaged social position in working populations also occurs in older age groups. Methods: This study examines the association of several indicators of social position with two measures of cortisol secretion, a product of the HPA axis. We examined the cortisol awakening response (CAR), and slope of the decline in cortisol secretion across the day. We examine whether the association is mediated by behavioral, psychosocial, and biological factors in 3992 participants of phase 7 (2002-2004) of the Whitehall 11 study, who provided six salivary cortisol samples across the day. Results: In this older cohort (mean age = 61 years; range = 50-74 years), lowest social position (assessed by current or previous occupational grade and wealth) was associated with a flatter slope in the decline in cortisol secretion. For example, over the course of the day, men in the lowest employment grades had a reduction in their cortisol by 0.125 (nmol/L/h), which was a shallower slope than those in the high grades (-0.129 nmol/L/h). The difference in slopes by employment grade among men, but not women, was statistically significant (p = .003). The difference in slopes was explained primarily by poor health and sleep behaviors, although financial insecurity also played a role. No effects were apparent with the CAR or other measures of social position. Conclusions: In men, poorer health and sleep behaviors (primarily smoking and short sleep duration), and financial insecurity mediate the impact of occupational status and wealth on cortisol secretion.