Department of Medical Psychology, the Air Force Hospital of Northern Theater PLA, 46 Xiaoheyan Road, Shenyang, 110000, Liaoning, China.
Department of Radiology, the First People's Hospital of Xianyang, 10 Biyuan Road, Xianyang, 712000, Shaanxi, China.
Lipids Health Dis. 2022 Apr 3;21(1):35. doi: 10.1186/s12944-022-01645-7.
Although high serum cholesterol is widely recognized as a major risk factor for heart disease, the health effects of low cholesterol are less clear. Several studies have found a correlation between low cholesterol and depression, but the results are inconsistent.
Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were utilized in this cross-sectional study. The analysis of the relationship between cholesterol and depression was performed at three levels: low total cholesterol, low high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol. The inclusion criteria were as follows: (1) people with low (<4.14 mmol/L) or normal (4.14-5.16 mmol/L) total cholesterol for Sample 1; people with low (<1 mmol/L) or normal (≥1 mmol/L) HDL cholesterol levels for Sample 2; and people with low (<1.8 mmol/L) or normal (1.8-3.4 mmol/L) LDL cholesterol levels for Sample 3; and (2) people who completed the Patient Health Questionnaire-9 depression scale. Age, sex, educational level, race, marital status, self-rated health, alcohol status, smoking status, body mass index (BMI), poverty income ratio, physical function, comorbidities, and prescription use were considered potential confounders. The missing data were handled by multiple imputations of chained equations. Logistic regression was used to assess the relationship between low cholesterol and depression.
After controlling for potential confounding factors in the multivariate logistic regression, no association was observed between depression and low total cholesterol (OR=1.0, 95% CI: 0.9-1.2), low LDL cholesterol (OR=1.0, 95% CI: 0.8-1.4), or low HDL cholesterol (OR=0.9, 95% CI: 0.8-1.1). The results stratified by sex also showed no association between low total cholesterol, low LDL cholesterol, low HDL cholesterol and depression in either men or women.
This population-based study did not support the assumption that low cholesterol was related to a higher risk of depression. This information may contribute to the debate on how to manage people with low cholesterol in clinical practice.
尽管高血清胆固醇被广泛认为是心脏病的主要危险因素，但低胆固醇对健康的影响尚不明确。一些研究发现低胆固醇与抑郁之间存在相关性，但结果并不一致。
本横断面研究利用了 2005-2018 年国家健康和营养检查调查（NHANES）的数据。在三个层次上分析胆固醇与抑郁之间的关系：总胆固醇低、高密度脂蛋白（HDL）胆固醇低和低密度脂蛋白（LDL）胆固醇低。纳入标准如下：（1）样本 1 中总胆固醇低（<4.14mmol/L）或正常（4.14-5.16mmol/L）的人群；样本 2 中 HDL 胆固醇水平低（<1mmol/L）或正常（≥1mmol/L）的人群；样本 3 中 LDL 胆固醇水平低（<1.8mmol/L）或正常（1.8-3.4mmol/L）的人群；（2）完成患者健康问卷-9 抑郁量表的人群。年龄、性别、教育水平、种族、婚姻状况、自评健康状况、酒精状况、吸烟状况、体重指数（BMI）、贫困收入比、身体功能、合并症和处方使用情况被认为是潜在的混杂因素。通过多个方程链的缺失数据处理。使用逻辑回归评估低胆固醇与抑郁之间的关系。
在多变量逻辑回归中控制了潜在的混杂因素后，抑郁与总胆固醇低（OR=1.0，95%CI：0.9-1.2）、LDL 胆固醇低（OR=1.0，95%CI：0.8-1.4）或 HDL 胆固醇低（OR=0.9，95%CI：0.8-1.1）之间无关联。按性别分层的结果也显示，男性或女性中总胆固醇低、LDL 胆固醇低、HDL 胆固醇低与抑郁之间均无关联。
这项基于人群的研究不支持低胆固醇与更高的抑郁风险相关的假设。这些信息可能有助于关于如何在临床实践中管理低胆固醇人群的争论。
