Association Between Cortisol to DHEA-s Ratio and Sickness Absence in Japanese Male Workers

  • Kumi Hirokawa
  • Yasuhito Fujii
  • Toshiyo Taniguchi
  • Jiro Takaki
  • Akizumi Tsutsumi



This study aimed to investigate the association between serum levels of cortisol and dehydroepiandrosterone sulfate (DHEA-s) and sickness absence over 2 years in Japanese male workers.


A baseline survey including questions about health behavior, along with blood sampling for cortisol and DHEA-s, was conducted in 2009. In total, 429 men (mean ± SD age, 52.9 ± 8.6 years) from whom blood samples were collected at baseline were followed until December 31, 2011. The hazard ratios (HR) and 95% confidence intervals (CI) for sickness absence were calculated using a Cox proportional hazard model, adjusted for potential confounders.


Among 35 workers who took sickness absences, 31 had physical illness. A high cortisol to DHEA-s ratio increased the risk of sickness absence (crude HR = 2.68, 95% CI 1.12–6.41; adjusted HR = 3.33, 95% CI 1.35–8.20). The cortisol to DHEA-s ratio was linearly associated with an increased risk of sickness absence (p for trend < .050). Single effects of cortisol and DHEA-s levels were not associated with sickness absences. This trend did not change when limited to absences resulting from physical illness.


Hormonal conditions related to the hypothalamus–pituitary–adrenocortical axis and adrenal function should be considered when predicting sickness absence. The cortisol to DHEA-s ratio may be more informative than single effects of cortisol and DHEA-s levels.


Cortisol DHEA-s Sickness absence Prospective study Japanese male workers 



This study was supported by the Japan Society for the Promotion of Science KAKENHI (grant number: 21700681) to Kumi Hirokawa.


This study was funded by the Japan Society for the Promotion of Science KAKENHI (grant number: 21700681).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© International Society of Behavioral Medicine 2017

Authors and Affiliations

  1. 1.Department of NursingBaika Women’s UniversityOsakaJapan
  2. 2.Department of Welfare System and Health ScienceOkayama Prefectural UniversityOkayamaJapan
  3. 3.Department of Public HealthSanyo Gakuen University Graduate School of NursingOkayamaJapan
  4. 4.Department of Public HealthKitasato University School of MedicineSagamiharaJapan

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