College of Nursing, University of South Florida, 12901 Bruce B. Downs Boulevard, MDN, Room 2010, Tampa, FL 33612-4476, USA.
J Clin Lipidol. 2013 May-Jun;7(3):208-16. doi: 10.1016/j.jacl.2013.01.004. Epub 2013 Feb 4.
Treatment guidelines for lipids have become increasingly more aggressive. However, naturally low or therapeutically reduced cholesterol levels may be associated with adverse psychological health symptoms, including depression, aggression, and hostility.
To examine relationships between low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels and measures of psychosocial status among middle-aged adults.
A total of 1995 subjects enrolled in the Heart Strategies Concentrating on Risk Evaluation study with data on TC, LDL cholesterol, and self-reported ratings of psychological health were evaluated. To quantify ratings of depression, aggression, cynicism, and hostility, psychological measures included the Center for Epidemiologic Studies Depression Scale (CES-D) and Cook-Medley Hostility Inventory.
Of 1995 participants, 25.1% were taking a lipid-lowering agent at baseline. Mean CES-D scores were similar between participants with low (<150 mg/dL) versus greater (≥150 mg/dL) TC and low (<100 mg/dL) versus higher (≥100 mg/dL) LDL cholesterol. However, among 22 participants with LDL cholesterol <70 mg/dL, the prevalence of clinically significant depressive symptomatology (CES-D score ≥16) was 31.8% compared with 12.1% in the remaining cohort (P = .005). In multivariable analysis, low LDL cholesterol (<100 mg/dL) was associated with cynicism (partial r = -0.14, P = .02) and hostility (partial r = -0.18, P = .004), but only in the subgroup of white subjects currently taking lipid-lowering medications. Low LDL cholesterol (versus non-low) was associated with greater aggression scores but only among participants currently taking psychiatric medications (3.4 ± 1.7 vs 2.8 ± 1.5, P = .02).
Our data indicate mixed evidence for independent relationships between low total and LDL cholesterol levels and impaired psychological health.
血脂治疗指南变得越来越严格。然而，胆固醇水平自然降低或经治疗降低可能与不良心理健康症状相关，包括抑郁、攻击和敌意。
探讨中年人群中总胆固醇（TC）和低密度脂蛋白（LDL）胆固醇水平低与心理社会状态测量指标之间的关系。
共有 1995 名参加心脏策略集中风险评估研究的受试者，其 TC、LDL 胆固醇和自我报告的心理健康评分数据进行了评估。为了量化抑郁、攻击、犬儒主义和敌意的评分，心理测量包括流行病学研究中心抑郁量表（CES-D）和库克-梅德利敌意量表。
在 1995 名参与者中，25.1%的人在基线时正在服用降脂药物。TC 低（<150mg/dL）与高（≥150mg/dL）和 LDL 胆固醇低（<100mg/dL）与高（≥100mg/dL）的参与者之间的 CES-D 评分相似。然而，在 LDL 胆固醇<70mg/dL 的 22 名参与者中，临床上显著的抑郁症状（CES-D 评分≥16）的患病率为 31.8%，而其余队列为 12.1%（P=0.005）。在多变量分析中，低 LDL 胆固醇（<100mg/dL）与犬儒主义（偏相关系数=-0.14，P=0.02）和敌意（偏相关系数=-0.18，P=0.004）相关，但仅在当前服用降脂药物的白人亚组中。低 LDL 胆固醇（与非低 LDL 胆固醇相比）与更强的攻击性评分相关，但仅在当前服用精神药物的参与者中（3.4±1.7 比 2.8±1.5，P=0.02）。
我们的数据表明，低总胆固醇和 LDL 胆固醇水平与心理健康受损之间存在相互矛盾的证据。
