Morgan R E, Palinkas L A, Barrett-Connor E L, Wingard D L
Department of Community and Family Medicine, School of Medicine, University of California, San Diego, La Jolla 92093-0628.
Lancet. 1993 Jan 9;341(8837):75-9. doi: 10.1016/0140-6736(93)92556-9.
In several clinical trials of interventions designed to lower plasma cholesterol, reductions in coronary heart disease mortality have been offset by an unexplained rise in suicides and other violent deaths. We have tried to find out whether depressive illness is related to low plasma cholesterol concentrations in men of 50 years and older. In 1985-87, Beck depression inventories were obtained from 1020 white men, aged 50-89 years, in the Rancho Bernardo, California, cohort. Disease history and behaviours were assessed by standard questionnaires. Plasma cholesterol and weight were measured at this time, as they had been in 1972-74. Among men aged 70 years and older, categorically defined depression was three times more common in the group with low plasma cholesterol (< 4.14 mmol/L) than in those with higher concentrations (5/31 [16%] vs 22/363 [6%]; p = 0.033). Depressive symptom scores correlated significantly and inversely with plasma cholesterol concentrations, even after adjustment for age, health status, number of chronic illnesses, number of medications, and exercise, as well as measured weight loss and change in plasma cholesterol in the previous 13 years. Our finding that low plasma cholesterol is associated with depressive symptoms in elderly men is compatible with observations that a very low total cholesterol may be related to suicide and violent death. Since cholesterol lowering in the general population is widely recommended, this observation warrants further investigation.
在几项旨在降低血浆胆固醇的干预措施的临床试验中，冠心病死亡率的降低被自杀及其他暴力死亡人数的不明上升所抵消。我们试图查明50岁及以上男性的抑郁症是否与低血浆胆固醇浓度有关。1985年至1987年，从加利福尼亚州兰乔贝纳多队列中1020名年龄在50至89岁的白人男性那里获取了贝克抑郁量表。通过标准问卷评估疾病史和行为。此时测量了血浆胆固醇和体重，就像在1972年至1974年所做的那样。在70岁及以上的男性中，明确界定的抑郁症在血浆胆固醇水平低（<4.14 mmol/L）的组中比在血浆胆固醇水平较高的组中常见3倍（5/31 [16%] 对22/363 [6%]；p = 0.033）。即使在对年龄、健康状况、慢性病数量、药物数量、运动以及测量的体重减轻和过去13年血浆胆固醇变化进行调整之后，抑郁症状评分仍与血浆胆固醇浓度呈显著负相关。我们发现老年男性低血浆胆固醇与抑郁症状有关，这与总胆固醇水平极低可能与自杀和暴力死亡有关的观察结果相符。由于普遍建议在普通人群中降低胆固醇，这一观察结果值得进一步研究。
