Lack of Replication of the Association of Low Serum Cholesterol and Attempted Suicide in Another Country Raises More Questions

Abstract

Background

In 2 Spanish case-control studies, low cholesterol levels in males were consistently associated with suicide attempts.

Methods

This US study tried to replicate the association between low cholesterol levels and suicide attempts, using a case-control design to study all patients admitted to Eastern State Hospital in Lexington, Kentucky, during a 1-year period. Psychiatric patients who had currently attempted suicide were studied as cases, and psychiatric patients who had not currently attempted suicide served as controls. A fasting serum total cholesterol <160 mg/dL was considered a possible risk factor for suicide. Logistic regression provided an adjusted estimate of the univariate odds ratios (ORs) for confounding factors.

Results

There were 193 current suicide attempters (cases) and 1091 noncurrent suicide attempters (controls). In the total sample logistic regression model, low cholesterol levels were significantly associated with lower risk of current suicide attempt (OR, 0.60; confidence interval (CI), 0.39 to 0.92) after adjusting for confounding variables. After sex stratification, low cholesterol levels were significant only among men (OR, 0.47; CI, 0.26 to 0.86). This US study did not replicate our prior Spanish findings; to the contrary, low cholesterol levels were not associated with increased suicide risk but with a decreased risk in US men.

Conclusions

It is possible cholesterol abnormalities and low body mass index may be markers of suicide risk, particularly in some male patients.