TY - JOUR PY - 1995// TI - Low serum cholesterol, violent death and serotonin metabolism: A review JO - Cardiovascular Risk Factors A1 - Steegmans, P.H.A. A1 - Bak, A.A.A. A1 - van der Does, E. A1 - Grobbee, D.E. A1 - Hoes, A.W. SP - 267 EP - 280 VL - 5 IS - 5 N2 - Several studies on low cholesterol (both primary and secondary prevention) have shown an increased risk of death from violent causes (suicide, accidents). Similar increased risks have been observed in some cholesterol lowering trials. Investigations on low cholesterol and behavior in animals and humans are scarce. Hypotheses to explain the association between low cholesterol and behavior propose either a direct effect of cholesterol on membranes or a concomitant change in other factors, such as fatty acid and tryptophan levels. The latter, more recent, hypothesis has been worked out most extensively and implies changes in brain serotonin levels, leading to depression, aggression, and impulsivity. Studies on serotonin and behavior suggest a relationship between low cholesterol levels and increased aggression and suicide. The association between cholesterol and brain serotonin levels was assessed in one animal study only, observing Increased aggression with low cholesterol levels. Future research should focus on strict assessment of the causes of death, and, specifically in trials, on behavioral baseline characteristics and changes thereof. Moreover, (indexes of) serotonin measurements should be carefully monitored. The distinction between a reduction in cholesterol of levels starting high and cholesterol levels that are chronically low needs to be appreciated.

Language: en

LA - en SN - 1130-7501 UR - http://dx.doi.org/ ID - ref1 ER -