Associations of socioeconomic and psychosocial factors with urinary measures of cortisol and catecholamines in the Multi-Ethnic Study of Atherosclerosis (MESA).
BACKGROUND
Stress hormones have been hypothesized to contribute to the social patterning of cardiovascular disease but evidence of differences in hormone levels across social groups is scant.


OBJECTIVE
To examine the associations of socioeconomic and psychosocial factors with urinary levels of cortisol and catecholamines and determine whether these associations are modified by race/ethnicity.


METHODS
Measures of cortisol, epinephrine, norepinephrine and dopamine were obtained on 12-h overnight urine specimens from 942 White, African American and Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Linear regression was used to examine associations of income-wealth index, education, depression, anger, anxiety and chronic stress with the four hormones after adjustment for covariates.


RESULTS
Higher income-wealth index was associated with lower levels of urinary cortisol, epinephrine, norepinephrine and dopamine, after adjustment for age, sex, race/ethnicity, medication use, body mass index, smoking, and alcohol use. Education and psychosocial factors were not associated with urinary stress hormone levels in the full sample. However, there was some evidence of effect modification by race: SES factors were more strongly inversely associated with cortisol in African Americans than in other groups and anger was inversely associated with catecholamines in African Americans but not in the other groups.


CONCLUSIONS
Lower SES as measured by income-wealth index in a multi-ethnic sample is associated with higher levels of urinary cortisol and catecholamines. Heterogeneity in these associations by race/ethnicity warrants further exploration.
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY 10032, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, United States. Electronic address: oc83@cumc.columbia.edu.
Cecilia
C
Castro-Diehl
Center for Social Epidemiology and Population Health, Department of Epidemiology, 109 Observatory Street, Room 3671, Ann Arbor, MI 48109, United States.
Ana V
AV
Diez Roux
Department of Medicine/Geriatrics, University of California, Los Angeles, CA 90095, United States.
Teresa
T
Seeman
Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY 10032, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, United States.
Steven
S
Shea
Department of Biostatistics at the University of Washington, Seattle, WA 98115, United States.
Sandi
S
Shrager
UCLA Research Center, University of California, Alhambra, CA 91801, United States.
Sameh
S
Tadros
D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000175:diagnosis / Q000523:psychology / Q000652:urine*; D001526:Behavioral Symptoms / Q000523:psychology* / Q000652:urine*; D002395:Catecholamines / Q000652:urine*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000523:psychology; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology
D002395:Catecholamines; D006854:Hydrocortisone
Multi-Ethnic of Atherosclerosis; Psychological factors; Race/ethnicity; Social factors; Urinary catecholamines; Urinary cortisol