Shin Hee-Young, Kang Gaeun, Kang Hee-Ju, Kim Sung-Wan, Shin Il-Seon, Yoon Jin-Sang, Kim Jae-Min
Department of Biomedical Science, Chonnam National University Medical School, 42 Jebongro, Dong-gu, Gwangju 501-746, Republic of Korea.
Division of Clinical Pharmacology, Chonnam National University Hospital, Gwangju, Republic of Korea.
J Affect Disord. 2016 Jan 1;189:192-8. doi: 10.1016/j.jad.2015.09.047. Epub 2015 Oct 8.
There have been inconsistent reports on the relationships between lipids and suicidality, and studies conducted in older adults are rare. This study examined associations between serum lipid levels and suicidal ideation in an older population.
This study used data obtained from a representative Korean sample of 4265 people age 65 years or older who completed a self-administered questionnaire about suicidal ideation over the last year. The fasting serum concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were measured and categorized into lower, intermediate (reference), and upper quartiles. A complex sample logistic regression stratified by gender was performed to determine the associations between serum lipid levels and suicidal ideation after controlling for covariates including age, education, marital status, current smoking, alcohol drinking, body mass index, hypertension, diabetes, diagnosed depression, antidepressant use, and lipid-lowering therapies.
In this study, the prevalence of suicidal ideation in an older Korean population was 22.9% (SE=0.9%). The prevalence was significantly higher in women than in men, 27.7% (1.2%) vs. 15.9% (1.1%) respectively. After adjusting for covariates, lower triglyceride levels were significantly associated with a decreased risk of suicidal ideation (OR=0.65; 95% CI=0.43-0.99) among men but no significant associations were observed among women. Additionally, there were no significant associations between any other measure of cholesterol levels and suicidal ideation in either men or women.
Cross-sectional design cannot infer temporality or the effects of changes in variables.
These results support the association between lower triglyceride levels and a reduced risk of suicidal ideation among Korean men over 65. Further studies are necessary to investigate gender difference and the biological mechanism.
关于脂质与自杀倾向之间的关系,报告结果并不一致,且针对老年人的相关研究较少。本研究调查了老年人群血清脂质水平与自杀意念之间的关联。
本研究使用的数据来自韩国一个具有代表性的样本,该样本包含4265名65岁及以上的老年人,他们完成了一份关于过去一年自杀意念的自填问卷。测量了空腹血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的浓度,并将其分为较低、中等(参考)和上四分位数。在控制了年龄、教育程度、婚姻状况、当前吸烟、饮酒、体重指数、高血压、糖尿病、诊断出的抑郁症、抗抑郁药使用和降脂治疗等协变量后,进行了按性别分层的复杂样本逻辑回归分析,以确定血清脂质水平与自杀意念之间的关联。
在本研究中,韩国老年人群中自杀意念的患病率为22.9%(标准误=0.9%)。女性的患病率显著高于男性,分别为27.7%(1.2%)和15.9%(1.1%)。在调整协变量后,较低的甘油三酯水平与男性自杀意念风险降低显著相关(比值比=0.65;95%置信区间=0.43 - 0.99),但在女性中未观察到显著关联。此外,男性和女性的其他胆固醇水平测量值与自杀意念之间均无显著关联。
横断面设计无法推断时间顺序或变量变化的影响。
这些结果支持了65岁以上韩国男性中较低的甘油三酯水平与自杀意念风险降低之间的关联。有必要进一步研究性别差异和生物学机制。