Life-time socio-economic position and cortisol patterns in mid-life.

The influence of adversity over long periods of the life-span on adult cortisol metabolism is not established. We assess whether morning cortisol levels are associated with socio-economic position (SEP) from birth to mid-adulthood, and if so, whether the association is due primarily to SEP in childhood, adulthood or both. Data are from 6335 participants in the 1958 British birth cohort, with salivary cortisol samples collected at 45 yr. Two saliva samples were obtained on the same day: 45 min post-waking (t1) and 3 h later (t2). Median t1 and t2 cortisol values were 18.80 and 7.10 nmol/l for men; 19.60 and 6.60 nmol/l for women. Three outcomes were constructed: (1) extreme t1 cortisol (top and bottom 5%), (2) area-under-curve (AUC), and (3) abnormal t1-t2 pattern. All three outcomes were associated with lifetime SEP but the relative contribution of childhood and adulthood SEP varied by outcome measure. Our results suggest that the impact of less advantaged SEP over a lifetime would lead to an approximate doubling of the proportion of extreme post-waking cortisol levels for both sexes; an 8% and 10% increase, respectively for females and males in AUC, and an increased risk of having an abnormal cortisol pattern of 60% and 91%. SEP differences were independent of time of waking and sample collection, and in most instances, remained after adjustment for smoking and body mas index (BMI). Thus, our study provides evidence for effects of chronic adversity on cortisol in mid-adult life.