Lower serum total cholesterol was associated with a 112% higher risk of suicidality (95% CI 40%-220%) compared with the highest serum TC category.
Meta-Analysis (n=510,392)
Are lower serum lipid levels associated with an increased risk of suicidality?
This meta-analysis demonstrates an inverse association between serum lipid levels, particularly total cholesterol, and the risk of suicidality.
Mean Difference: -22.35 (95% CI -27.95–-16.75)
BACKGROUND: We conducted a systematic review and meta-analysis to determine the association between serum lipid levels and suicidality, as evidence from previous studies has been inconsistent. METHODS: We identified relevant studies by searching Medline, Web of Science, EMBASE, and the Cochrane Database of Systematic Reviews (1980 to Dec. 5, 2014). Studies assessing the association between serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) levels and suicidality were included. We used a random-effects model to take into account heterogeneity among studies. RESULTS: We included 65 studies with a total of 510 392 participants in our analysis. Compared with the nonsuicidal patients, suicidal patients had significantly lower serum TC (weighted mean difference WMD -22.35, 95% confidence interval CI -27.95 to -16.75), LDL-C (WMD -19.56, 95% CI -26.13 to -12.99) and TG (WMD -23.40, 95% CI -32.38 to -14.42) levels, while compared with the healthy controls, suicidal patients had significantly lower TC (WMD -24.75, 95% CI -27.71 to -21.78), HDL-C (WMD -1.75, 95% CI -3.01 to -0.48) and LDL-C (WMD -3.85, 95% CI -7.45 to -0.26) levels. Furthermore, compared with the highest serum TC level category, a lower serum TC level was associated with a 112% (95% CI 40%-220%) higher risk of suicidality, including a 123% (95% CI 24%-302%) higher risk of suicide attempt and an 85% (95 CI 7%-221%) higher risk of suicide completion. The cut-off values for low and high serum TC level were in compliance with the categories reported in the original studies. LIMITATIONS: A major limitation of our study is the potential heterogeneity in most of the analyses. In addition, the suicidal behaviour was examined using different scales or methods across studies, which may further explain heterogeneity among the studies. CONCLUSION: We identified an inverse association between serum lipid levels and suicidality. More mechanistic studies are needed to further explain this association.
Wu et al. (Wed,) conducted a meta-analysis in Suicidality (n=510,392). Lower serum total cholesterol (TC) vs. Nonsuicidal patients was evaluated on Serum total cholesterol (TC) difference between suicidal and nonsuicidal patients (WMD -22.35, 95% CI -27.95 to -16.75). Lower serum total cholesterol was associated with a 112% higher risk of suicidality (95% CI 40%-220%) compared with the highest serum TC category.