| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Total cholesterol and death from coronary heart disease in older persons Grossman, C. M. (1998), Ann Intern Med 128(3): 242-3. |
| Total cholesterol and HDL-cholesterol in relation to socioeconomic status in a sample of 11,645 Greek adults: the EPIC study in Greece. European Prospective Investigation into Nutrition and Cancer Benetou, V., Y. Chloptsios, et al. (2000), Scand J Public Health 28(4): 260-5. Abstract: OBJECTIVE: To examine the relationship between educational level, a powerful indicator of socioeconomic status in Greece, total cholesterol and HDL-cholesterol in a large sample of Greek adults. METHODS: The study sample consisted of 11,645 subjects, 4,398 men and 7,247 women, aged 23-86 years, who voluntarily participated in the Greek component of the EPIC study during 1994-98. Educational attainment was divided into low, medium, and high. Linear regression analyses were performed, in men and women separately, using total and HDL-cholesterol as dependent variables and educational level as independent, while controlling for age. RESULTS: Total blood cholesterol values are inversely associated with educational level in both genders, a pattern contrasting with that found 20 years ago. The association is more prominent among women. HDL-cholesterol values are inversely associated with educational level in men, whereas the association is less consistent in women. |
| Total cholesterol and high density lipoprotein cholesterol as important predictors of erectile dysfunction Wei, M., C. A. Macera, et al. (1994), Am J Epidemiol 140(10): 930-7. Abstract: Although erectile dysfunction is frequently seen in patients with manifestations of arteriosclerotic disease, the independent contribution of serum cholesterol in predicting erectile dysfunction is unclear. The aim of this study was to examine the relation between serum cholesterol and erectile dysfunction. Medical histories, physical examinations, and blood tests were obtained at Cooper Clinic, Dallas, Texas, from 3,250 men aged 26-83 years (mean, 51 years) without erectile dysfunction at their first visit, who had one more clinic visit, all between 1987 and 1991. These men were followed 6-48 months after the first clinic visit (mean, 22 months). Erectile dysfunction was reported in 71 men (2.2%) during follow-up. Every mmol/liter of increase in total cholesterol was associated with 1.32 times the risk of erectile dysfunction (95% confidence interval 1.04-1.68), while every mmol/liter of increase in high density lipoprotein cholesterol was associated with 0.38 times the risk (95% confidence interval 0.18-0.80). Men with a high density lipoprotein cholesterol measurement over 1.55 mmol/liter (60 mg/dl) had 0.30 times the risk (95% confidence interval 0.09-1.03) as did men with less than 0.78 mmol/liter (30 mg/dl). Men with total cholesterol over 6.21 mmol/liter (240 mg/dl) had 1.83 times the risk (95% confidence interval 1.00-3.37) as did men with less than 4.65 mmol/liter (180 mg/dl). Those differences remained essentially unchanged after adjustment for other potential confounders. The authors conclude that a high level of total cholesterol and a low level of high density lipoprotein cholesterol are important risk factors for erectile dysfunction. |
| Total cholesterol and high-density lipoprotein cholesterol in patients with non-insulin-dependent diabetes mellitus Dias, C. M., P. Nogueira, et al. (1995), Acta Med Port 8(11): 619-28. Abstract: Non-insulin-dependent diabetics often have quantitative changes in plasma lipid profiles characterised by higher triglycerides and lower HDL-cholesterol than the average population. This paper summarises the cross-sectional data (reported by the general practitioners participating in Medicos-Sentinela) concerning total and HDL-cholesterol in a cohort of non-insulin-dependent diabetics treated at primary care settings in Portugal. Total cholesterol and High Density Lipoprotein (HDL) associated cholesterol were significantly higher in women. Total cholesterol increased significantly with age (in women), regular alcohol intake, body mass index, systolic blood pressure and diastolic blood pressure (in males). HDL-cholesterol showed significant increase with age (both sexes and males only), gender, and alcohol intake in males. The increase in total cholesterol found in patients with regular alcohol intake is an infrequently reported finding. |
| Total cholesterol and high-density lipoprotein levels as risk factors for increased intraocular pressure Stewart, W. C., C. Sine, et al. (1996), Am J Ophthalmol 122(4): 575-7. Abstract: PURPOSE: To determine whether high-density lipoprotein and total cholesterol levels were risk factors for increased intraocular pressure in patients with chronic open-angle glaucoma or ocular hypertension. METHODS: We measured total cholesterol, high-density lipoprotein, and total cholesterol/high-density lipoprotein ratio in 25 patients with open-angle glaucoma or ocular hypertension who had taken no glaucoma medications for four weeks. We individually matched these patients to 25 control subjects who had no history of open-angle glaucoma or ocular hypertension, on the basis of age, race, gender, and history of vascular disease or diabetes mellitus. RESULTS: We found no statistical difference in the high-density lipoprotein (P =.702) or total cholesterol (P =.177) levels or total cholesterol/high-density lipoprotein ratio between groups (P =.178, paired t test). CONCLUSION: This study indicates that increased high-density lipoprotein and total cholesterol levels are not risk factors for increased intraocular pressure. |
| Total cholesterol and mortality after age 80 years Jonsson, A., H. Sigvaldason, et al. (1997), Lancet 350(9093): 1778-9. |
| Total cholesterol and mortality in China, Poland, Russia, and the US Cai, J., A. Pajak, et al. (2004), Ann Epidemiol 14(6): 399-408. Abstract: PURPOSE: To examine the relationships of total and cause-specific mortality to serum cholesterol in four diverse populations. METHODS: Chinese, Polish, Russian, and US population-based samples were studied. The relationship between cholesterol levels and mortality was assessed by Cox proportional hazard regression with restricted piecewise cubic splines. RESULTS: The cholesterol and total mortality relationship was statistically significantly J-shaped for all men combined. In country-specific relationships, cholesterol was significantly, linearly, and positively related to total mortality in Russian and US men. For women, the relationship was non-linear, but not statistically significant, and became statistically significant upon adjustment for other risk factors. For Polish women, a statistically significant inverse relationship existed. CHD mortality and cardiovascular disease (CVD) mortality increased linearly with cholesterol in Polish, Russian, and US men and the aggregate of men, but there was no relationship for women. Cancer mortality was not related to cholesterol except for the Polish cohort and Russian women, where there was an inverse relationship. CONCLUSIONS: Serum cholesterol was a strong, consistent predictor of CHD and CVD mortality in Polish, Russian, and US men despite their social diversity. In contrast to CHD mortality, the relation of cholesterol to total mortality and non-CVD mortality varied by country and gender. |
| Total cholesterol and mortality in patients with pre-existing coronary artery disease Gupta, R. and K. D. Gupta (1992), Natl Med J India 5(3): 111-4. Abstract: BACKGROUND. A positive correlation exists between serum cholesterol levels and cardiovascular mortality. However, the role of serum cholesterol in persons with pre-existing coronary artery disease is not clear. METHODS. A cohort of 524 patients with coronary artery disease was divided into four groups based on the total serum cholesterol values. Group I consisted of 68 patients with cholesterol levels of 200 mg/dl or less; Group II of 116 patients with cholesterol levels between 201 and 220 mg/dl; Group III of 187 patients with levels between 221 and 240 mg/dl and Group IV of 153 patients with cholesterol levels greater than 240 mg/dl. RESULTS. Actuarial survival analysis over an 11-year follow up did not show any overall difference in mortality between these groups (Logrank test statistic = 1.89, p > 0.1). Analysis after adjustment of the data also showed that mortality rates were not different (chi (2) = 4.73, p > 0.05). Hazard function analysis indicated that death rates per thousand person years of follow up were 49.97 +/- 8.4 in Group I, 41.38 +/- 8.4 in Group II, 55.39 +/- 4.4 in Group III and 45.38 +/- 6.4 in Group IV. These were also not statistically significant. Comparison of mortality rates in patients with angina pectoris and past myocardial infarction also showed similar results. CONCLUSION. Total serum cholesterol levels do not influence long term survival in patients with pre-existing coronary artery disease. |
| Total cholesterol and mortality in the elderly Casiglia, E., A. Mazza, et al. (2003), J Intern Med 254(4): 353-62. Abstract: OBJECTIVE: To evaluate, at a population level, whether total cholesterol (TC) is a risk factor of mortality. To verify whether or not this is true for both genders. DESIGN: Population-based, long-lasting, prospective study. SETTING: Institutional epidemiology in primary care. SUBJECTS: A total of 3257 subjects aged 65-95 years, recruited from Italian general population. INTERVENTION: None. MAIN OUTCOME MEASURES: Total cholesterol was measured, analysed as a continuous variable and then divided into quintiles and re-analysed. For each quintile, the multivariate relative risk (RR) of mortality adjusted for confounders was calculated in both genders. Stratification of mortality risk by TC quintiles, body mass index and cigarette smoking was also performed in both genders. RESULTS: Total cholesterol levels directly predicted coronary mortality in men RR being in the fifth rather than in the first quintile: 2.40 (1.40-4.14) and any other mortality in women. It also inversely predicted miscellaneous mortality in both genders. This trend was more evident when low cholesterol was associated with malnutrition or smoking. CONCLUSIONS: High TC remains a strong risk factor for coronary mortality in elderly men. On the other hand, having a very low cholesterol level does not prolong survival in the elderly; on the contrary, low cholesterol predicts neoplastic mortality in women and any other noncardiovascular mortality in both genders. |
| Total cholesterol and risk of mortality in the oldest old Weverling-Rijnsburger, A. W., G. J. Blauw, et al. (1997), Lancet 350(9085): 1119-23. Abstract: BACKGROUND: The impact of total serum cholesterol as a risk factor for cardiovascular disease decreases with age, which casts doubt on the necessity for cholesterol-lowering therapy in the elderly. We assessed the influence of total cholesterol concentrations on specific and all-cause mortality in people aged 85 years and over. METHODS: In 724 participants (median age 89 years), total cholesterol concentrations were measured and mortality risks calculated over 10 years of follow-up. Three categories of total cholesterol concentrations were defined: < 5.0 mmol/L, 5.0-6.4 mmol/L, and > or = 6.5 mmol/L. In a subgroup of 137 participants, total cholesterol was measured again after 5 years of follow-up. Mortality risks for the three categories of total cholesterol concentrations were estimated with a Cox proportional-hazards model, adjusted for age, sex, and cardiovascular risk factors. The primary causes of death were coded according to the International Classification of Diseases (ICD-9). FINDINGS: During 10 years of follow-up from Dec 1, 1986, to Oct 1, 1996, a total of 642 participants died. Each 1 mmol/L increase in total cholesterol corresponded to a 15% decrease in mortality (risk ratio 0.85 95% CI 0.79-0.91). This risk estimate was similar in the subgroup of participants who had stable cholesterol concentrations over a 5-year period. The main cause of death was cardiovascular disease with a similar mortality risk in the three total cholesterol categories. Mortality from cancer and infection was significantly lower among the participants in the highest total cholesterol category than in the other categories, which largely explained the lower all-cause mortality in this category. INTERPRETATION: In people older than 85 years, high total cholesterol concentrations are associated with longevity owing to lower mortality from cancer and infection. The effects of cholesterol-lowering therapy have yet to be assessed. |
| Total cholesterol and suicidality in depression Sullivan, P. F., P. R. Joyce, et al. (1994), Biol Psychiatry 36(7): 472-7. Abstract: There exists considerable controversy regarding an association between low total cholesterol and increased mortality from suicide. As suicide mortality is a crude marker for suicidal ideation and behavior, we investigated the association between total cholesterol and suicidality in a depressed sample. Ninety men and women meeting structured criteria for a major depressive episode of at least moderate severity participated in a study of predictors of treatment response. A three level variable codified the degree of suicidality in the previous month: no suicidal thoughts (39/90), suicidal ideation or plan (38/90), and a suicide attempt (13/90). There was a significant univariate association between lower cholesterol levels and increasing degrees of suicidality. In a multivariate analysis, this association was the only one that neared statistical significance (p = 0.068). Although it is premature to conclude that these variables are causally associated, data from a number of sources suggest that this association is worthy of further study. |
| Total cholesterol as a risk factor in stroke Jacobs, D. R., Jr. and H. Iso (1991), Stroke 22(10): 1329-30. |
| Total cholesterol concentration and mortality at a relatively young age: do men and women differ? Monique Verschuren, W. M. and D. Kromhout (1995), Bmj 311(7008): 779-83. Abstract: OBJECTIVE--To investigate the relation between total cholesterol concentration and mortality from coronary heart disease, cardiovascular diseases, non-cardiovascular causes, and all causes. DESIGN--Population based cohort study. SUBJECTS--23,000 men and 26,000 women aged 30-54 years examined between 1974 and 1980. MAIN OUTCOME MEASURES--Mortality for the above mentioned end points for fifths of cholesterol distribution, and relative risks estimated by using Cox's proportional hazard (survival) analysis. Adjustment was made for age, smoking, systolic blood pressure, and body mass index. RESULTS--Mortality from coronary heart disease in men was five times higher than that in women. A strong positive association between total cholesterol concentration and mortality from coronary heart disease and cardiovascular diseases was observed in both men and women. The relative risk for the highest compared with the lowest fifth of the cholesterol distribution was for mortality from coronary heart disease (3.0 (95% confidence interval 1.8 to 5.1) in men and 3.8 (1.1 to 13.1) in women) and for mortality from cardiovascular disease (2.8 (1.8 to 4.2) in men and 2.9 (1.4 to 6.0) in women). No increase of non-cardiovascular mortality at low cholesterol concentration was observed. All cause mortality was significantly higher in the highest compared with the lowest fifth of the cholesterol distribution: relative risk 1.6 (1.3 to 2.0) in men and 1.5 (1.1 to 1.9) in women. CONCLUSION--Total cholesterol concentration is a strong predictor of mortality from coronary heart disease, cardiovascular diseases, and all causes in women as well as in men. Low cholesterol concentrations are not associated with increased mortality from non-cardiovascular causes. |
| Total cholesterol correlates with cyclosporine C2 levels in kidney transplant recipients under maintenance immunosuppression Cardinal, H., A. A. Barama, et al. (2004), Transplant Proc 36(2 Suppl): 448S-450S. Abstract: The aim of this study was to assess the relationship between cyclosporine (CyA) trough level (C0) and 2-hour postdose (C2) and total cholesterol (TC) in kidney transplant (KT) recipients on Neoral maintenance immunosuppression. In KT recipients who had more than 5 years of follow-up, stable graft function, and stable Neoral dose, we measured C2 and C0 blood levels, serum creatinine, mean total cholesterol (TC) over the last 5 years, prednisone dose, use of beta-blockers and thiazides. Correlations between C0 and C2 levels and TC were performed with the Pearson coefficient. Receiver operating characteristics (ROCs) were used to define the threshold with greater accuracy for significant variables at the correlation test. Statistical tests were performed with SPSS 9.5 The C2 correlated with TC (0.31; P=.008) whereas C0 did not. The C2 level was an independent predictor for TC after adjusting for recipient age, gender, dose of prednisone, creatinine clearance, and use of beta-blockers and thiazides (B coefficient=1.124(E-3); P=.009). A threshold C2 value of 700 microg/L yielded to a TC level of 5.2 mmol/L. This is the first study to report a correlation between C2 levels and TC. Although C2 explained a small fraction of TC variability, it is an independent predictor of TC in KT recipients on Neoral maintenance immunosuppression. A long-term C2 value under 700 microg correlates with better control of hypercholesterolemia. |
| Total cholesterol, free cholesterol Maeda, T. and T. Teramoto (1999), Nippon Rinsho 57 Suppl: 13-5. |
| Total cholesterol, HDL-cholesterol and blood pressure in relation to life style: results of the first population screening of the Swiss MONIKA Project Marti, B., S. Dai, et al. (1990), Schweiz Med Wochenschr 120(51-52): 1976-88. Abstract: To evaluate the association of individual health habits with levels of cardiovascular risk factors such as serum cholesterol and blood pressure, data from a representative population sample of 860 men and 788 women, aged 25 to 64 years and residing in Western Switzerland, were analyzed cross-sectionally. The data had been collected during 1984/85 as a part of the WHO MONICA project, an international research project on the epidemiology of cardiovascular diseases. In age-adjusted analysis, a score of prudent diet was a reasonably strong inverse correlate of total cholesterol in men (p less than 0.001) but less so in women (p = 0.11); the diet score was unrelated to HDL cholesterol. In both genders, alcohol consumption was associated with elevated levels of systolic and diastolic blood pressure (men: both p less than 0.001; women: p = 0.05 and 0.01 respectively) and of HDL cholesterol (men and women: p less than 0.001). Coffee consumption was unrelated to either blood lipids or blood pressure. In both men and women, leisure-time exercise was a predictor of a low-risk lipid profile, i.e. a low total cholesterol/HDL ratio (both p less than 0.001). Better educated persons, especially women, revealed consistently lower levels of cardiovascular risk factors. The independent character of these lifestyle-risk factor-associations was largely confirmed in a multivariate analysis, with cigarette smoking emerging as another significant predictor of a deteriorated lipid profile, while education was not an independent determinant of biological risk factors. Lifestyle variables, including body mass index, explained 9 to 19% of variance in cardiovascular risk factors, with relative weight being the strongest of the predictors related to behaviour. Entering age and sex into the regression models enhanced the predictive power of the equations to 16 to 26% explained risk factor variance. We conclude from this population-based, cross-sectional study that personal health habits such as diet, exercise, alcohol consumption and smoking, as well as body weight are significantly and independently related to blood lipid and blood pressure levels; the apparent size of effect of these behavioural traits on biological risk factors for cardiovascular diseases was only modest, but it may nevertheless be relevant to prevention. |
| Total cholesterol, HDL-cholesterol, and risk of nosocomial infection: a prospective study in surgical patients Delgado-Rodriguez, M., M. Medina-Cuadros, et al. (1997), Infect Control Hosp Epidemiol 18(1): 9-18. Abstract: OBJECTIVE: To study the relationship between serum high-density lipoprotein cholesterol (HDL-C), total serum cholesterol, and nosocomial infection in patients undergoing general surgery. DESIGN: Prospective cohort study, with an extended follow-up to 1 month after hospital discharge. SETTING: The general surgery service of a tertiary hospital. MAIN OUTCOME MEASURE: Nosocomial infection, mainly surgical-site infection (SSI), urinary tract infection, respiratory tract infection (RTI), and bacteremia. PATIENTS: 1,267 surgery patients aged 10 to 92 years. RESULTS: 182 subjects acquired 194 nosocomial infections, a cumulative incidence of 14.5%; most (116, 62.3%) were postoperative wound infections. There was an increase in infection risk at low levels of HDL-C, and both low and high total cholesterol levels. After adjusting simultaneously for several confounders, including total cholesterol, low levels of HDL-C (< or = 20 mg/dL) yielded an odds ratio (OR) of 2.2 (95% confidence interval CI95, 0.6-7.9) for SSI and an OR of 10.3 (CI95, 0.7-151.5) for RTI. Otherwise, no trend was observed between HDL-C levels and infection risk, and no increased risk of nosocomial infection was observed for HDL-C values in the range of 21 to 49 mg/dL. Serum cholesterol showed a U-shaped relationship with nosocomial infection risk. Both low levels (below 102 mg/dL) and high levels (above 290 mg/dL) of total cholesterol were associated with a higher risk of SSI (mainly those caused by gram-negative bacteria) and RTI in comparison with the reference group (139-261 mg/dL). CONCLUSIONS: Serum HDL-C and total cholesterol seem to be associated with the risk of nosocomial infection in surgical patients. |
| Total cholesterol, high density lipoprotein cholesterol and steroid hormone changes in normal weight women during the menstrual cycle Nduka, E. U. and E. O. Agbedana (1993), Int J Gynaecol Obstet 41(3): 265-8. Abstract: OBJECTIVE: To study total cholesterol, high density lipoprotein cholesterol and steroid changes in normal weight women during the menstrual cycle. METHOD: Multiple point blood samples obtained at different phases of the menstrual cycle in 14 student nurses, consuming normal Nigerian diets (rich in vegetable based proteins and fiber), were analyzed for HDL cholesterol, total cholesterol and for the steroids progesterone, estradiol and testosterone by RIA. RESULTS: A multivariate repeated measures analysis was carried out according to Pillais, Hotelings Willes and Roys tests and the three phases of menstrual cycle were found to be significantly different with the significance level at 0.030. CONCLUSION: The fluctuations in plasma lipids that occur at different phases of the menstrual cycle have important implications in evaluating the factors of coronary heart disease in women of reproductive age. Also, the results suggest that multiple point measurements may give a better estimate of plasma lipid changes in blood in women of reproductive age. |
| Total cholesterol, high-density lipoprotein cholesterol, and triglycerides in children receiving antiepileptic drugs Franzoni, E., M. Govoni, et al. (1992), Epilepsia 33(5): 932-5. Abstract: The influence of antiepileptic drug (AED) therapy on total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides was studied in 208 epileptic children compared with 175 normal children. A significant increase in TC plasma levels was observed with carbamazepine (CBZ), phenobarbital (PB), and phenytoin (PHT). The patients receiving valproate (VPA) showed levels very similar to those of the control population. The results may be explainable by the different biotransformation pathway of these drugs. HDL cholesterol and triglycerides were not altered by any of the AEDs. We recommend monitoring TC level in patients receiving CBZ, PB, and PHT and prescription of diet treatment, at least during the time of AED treatment. |
| Total cholesterol, LDL-cholesterol and apoprotein B in umbilical cord blood: cross-sectional study Averna, M. R., C. M. Barbagallo, et al. (1992), Minerva Pediatr 44(9): 395-9. Abstract: The aim of the present study was to evaluate, in a large series of term newborns, the prevalence of hypercholesterolemia in cord blood, using as parameters, levels of plasma cholesterol, LDL-cholesterol and apo B higher than mean + 2 standard deviations, alone or in association. Data reported here represent the results of a transversal study. 1275 term newborns were studied. In everybody, in cord blood samples, at birth, cholesterol, triglycerides, HDL-cholesterol, apoprotein B and LDL-cholesterol have been assayed. In 3.13% of them (40 subjects), cholesterol levels > mean + 2 standard deviations were present. Moreover, only 6 subjects (0.47%) showed all three parameter levels higher than mean + 2 standard deviations, and 4 subjects (0.31%), in spite of normal cholesterol levels, presented high LDL-cholesterol and apo B levels. Integrated utilization of these parameters in the neonatal screening of familial hypercholesterolemia will have to be confirmed by follow-up studies. |