Contradicting reports...
Low serum cholesterol concentration and risk of suicide.
Recent reports have suggested a link between low serum total cholesterol and risk of death from suicide. We examined this association using participants in the 1970-1972 Nutrition Canada Survey. We determined the mortality experience of Nutrition Canada Survey participants older than 11 years of age at baseline through 1993 by way of record linkage to the Canadian National Mortality Database. The relation between low serum total cholesterol and mortality from suicide was assessed using a stratified analysis (N = 11,554). There were 27 deaths due to suicide. Adjusting for age and sex, we found that those in the lowest quartile of serum total cholesterol concentration (<4.27 mmol/liter) had more than six times the risk of committing suicide (rate ratio = 6.39; 95% confidence interval = 1.27-32.1) as did subjects in the highest quartile (>5.77 mmol/liter). Increased rate ratios of 2.95 and 1.94 were observed for the second and third quartiles, respectively. The effect persisted after the exclusion from the analysis of the first 5 years of follow-up and after the removal of those who were unemployed or who had been treated for depression. These data indicate that low serum total cholesterol level is associated with an increased risk of suicide.
Serum cholesterol concentration and death from suicide in men: Paris prospective study I
Abstract
Objective: To investigate whether low serum cholesterol concentration or changing serum cholesterol concentration is associated with risk of suicide in men.
Design: Cohort study with annual repeat measurements of serum cholesterol concentration (for up to four years).
Setting: Paris, France.
Subjects: 6393 working men, aged 43-52 in 1967-72, who had at least three measurements of serum cholesterol concentration.
Main outcome measures: Individual change over time in serum cholesterol concentration (estimated using within person linear regression method); death from suicide during average of 17 years' follow up after last examination.
Results: 32 men committed suicide during follow up. After adjustment for age and other factors, relative risk of suicide for men with low average serum cholesterol concentration (<4.78 mmol/l) compared with those with average serum cholesterol concentration of 4.78-6.21 mmol/l was 3.16 (95% confidence interval 1.38 to 7.22, P = 0.007). Men whose serum cholesterol concentration decreased by more than 0.13 mmol/l a year had multivariate adjusted relative risk of 2.17 (0.97 to 4.84, P = 0.056) compared with those whose cholesterol remained stable (change of </=0.13 mmol/l a year).
Conclusion: Both low serum cholesterol concentration and declining cholesterol concentration were associated with increased risk of death from suicide in men. Although there is some evidence in favour of a concomitant rather than a causal effect for interpreting these associations, long term surveillance of subjects included in trials of lipid lowering treatments seems warranted.
High Serum Cholesterol and Risk of Suicide
Objective: The study was conducted to estimate the association between serum total cholesterol concentration and mortality from suicide.
Method: The baseline serum total cholesterol concentration of 37,635 adults was determined in five independent population surveys conducted during 1972–1992 in Finland. Mortality from different causes of death was monitored for a mean of 14.6 years after the survey dates. The means for violent suicides (N=130) included hanging, firearms, cutting, jumping, and unspecified means. The means for nonviolent suicides (N=46) included drug overdose, poisoning with gases, and drowning.
Results: Serum total cholesterol concentration was positively related to the risk of violent suicide. Among subjects whose serum total cholesterol concentration was in the highest category, the adjusted relative risk was more than twofold compared with the lowest category. The violent/nonviolent suicide ratio increased linearly with increasing cholesterol category. No association between serum total cholesterol concentration and the risk of nonviolent suicide was found.
Conclusions: This is the first study to demonstrate the positive relationship of high serum total cholesterol concentration with increased risk of violent suicide.