Sexual orientation and salivary alpha-amylase diurnal rhythms in a cohort of U.S. young adults

Psychoneuroendocrinology. 2018 Nov:97:78-85. doi: 10.1016/j.psyneuen.2018.07.006. Epub 2018 Jul 10.


Sexual minorities in the United States are at elevated risk of prejudice, discrimination, and violence victimization due to stigma associated with their sexual orientation. These stressors may contribute to physiological stress responses and changes in the regulation of the sympathetic nervous system (SNS). To date, no studies have examined the associations among minority sexual orientation, recent stressful events, and diurnal salivary alpha-amylase (sAA) patterns. The present study included 1663 young adults ages 18-32 years (31% men, 69% women) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over the course of one day to estimate diurnal sAA patterns. Sexual orientation groups included completely heterosexual with no same-sex partners (CH; referent), mostly heterosexual/completely heterosexual with same-sex partners, and gay/lesbian/bisexual (LB or GB). Sex-stratified multilevel models were fit to evaluate the association of sexual orientation with diurnal patterns of log sAA. The association of recent stressful events was also evaluated. Among women, sexual minorities scored significantly higher than CH on perceived stress and number of stressful events in the past month (p < 0.05). Among men, sexual minorities scored higher than CH on perceived stress but not recent stressful events. In multivariable models, recent stressful events were not associated with sAA patterns, but significant sexual orientation group differences in sAA diurnal rhythm were observed among women though not among men. Compared to CH women, LB showed a blunted awakening response and elevated sAA levels across the day, both indicators consistent with SNS dysregulation. Findings suggest dysregulation of stress physiology in LB women, but not other sexual minority women or men, relative to same-sex heterosexuals. Observed dysregulation may relate to exposure among LB women to chronic stressors associated with sexual orientation stigma, although these relations and differences by sex warrant further study.

Keywords: Alpha-amylase; Diurnal rhythm; SNS; Sexual orientation; Sympathetic nervous system; Young adults; sAA.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Affect / physiology
  • Anxiety / metabolism*
  • Anxiety Disorders / metabolism
  • Biomarkers
  • Bisexuality
  • Case-Control Studies
  • Circadian Rhythm
  • Cohort Studies
  • Female
  • Heterosexuality
  • Humans
  • Hydrocortisone / analysis
  • Male
  • Prospective Studies
  • Saliva / chemistry
  • Salivary alpha-Amylases / analysis*
  • Sexual Behavior / psychology
  • Sexual and Gender Minorities / psychology*
  • Social Stigma
  • United States
  • Young Adult
  • alpha-Amylases / analysis


  • Biomarkers
  • Salivary alpha-Amylases
  • alpha-Amylases
  • Hydrocortisone