
LOW cholesterol increases death?! | New study
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low cholesterol & mortality. meaning re:cholesterol?
people with high cholesterol AND low or normal cholesterol = more death (cholesterol paradox). lowest mortality = 140mg/dL LDL-cholesterol.
low/normal cholesterol is lethal? association between low cholesterol and mortality: death goes up at very high cholesterol and low/normal cholesterol
low cholesterol could cause death but studies only show co-occurrence of low cholesterol/death. people with low cholesterol could have other differences. Same for high cholesterol. We covered high cholesterol before
So low cholesterol and death co-occur. low cholesterol could cause death or other factor causes both low cholesterol and death. something causes low cholesterol AND death?! low cholesterol common in cancer. tumor cells accumulate cholesterol. accumulation of cholesterol is general feature of cancer. after chemotherapy cholesterol rises
liver disease: cholesterol can be low. so several diseases can lower cholesterol. so Low cholesterol may cause death or low cholesterol may co-occur with death but not cause death
cholesterol-lowering meds, statins: If low cholesterol kills, lowering it causes death. cholesterol reduced by statins = more death? if low cholesterol is innocent, artificially lowering should not cause death
people on statins do not die more even with lower cholesterol. unlike people not on statins. low cholesterol isn’t the cause
doesn’t seem low cholesterol causes death. “incorrect to use data against lipid lowering for cardiovascular disease and mortality”; “decrease in cholesterol likely due to debilitation”. cholesterol goes down because of illness? low cholesterol not causal
if disease reduces cholesterol, stable low cholesterol shouldn't mean more death. if low cholesterol is the killer, whether cholesterol drops or is always low = trouble
cholesterol drop coincides with cancer and death. always low cholesterol = no risk. So problem isn’t low cholesterol.
authors: "low cholesterol = tumor or liver disease?”
bag 3: manipulate cholesterol. people on statins don’t die more but maybe people on statins exercise more
If low cholesterol kills, lowering it with meds causes death
RCTs: lowered LDL-cholesterol and death did not go up
lowered LDL-cholesterol, death went down. less mortality with cholesterol lowering. 26 cholesterol-lowering trials: mortality reduced. 10% less death per unit of cholesterol drop. either no change in death or less death with low cholesterol
different cholesterol-lowering drugs = similar effect. people with low cholesterol (genetics or diet): similar, total death constant or lower
actively lowering cholesterol lowers cardiovascular risk and maybe risk of death. if cholesterol drops spontaneously, cholesterol just creeps over the years, could be a red flag
"our results say nothing about role of cholesterol in cardiovascular disease, mortality, cholesterol lowering"
cholesterol paradox: similar for BMI. weight loss due to disease. same with cholesterol. our society is hypercholesterolemic
normal cholesterol + lower mortality = possible
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References:
U-curve: https://www.bmj.com/content/371/bmj.m4266
https://www.nature.com/articles/s41598-018-38461-y
letter: https://www.bmj.com/content/371/bmj.m4266/rapid-responses
cholesterol & disease:
https://pubmed.ncbi.nlm.nih.gov/8739854/
https://www.degruyter.com/document/doi/10.1515/hsz-2014-0194/html
https://pubmed.ncbi.nlm.nih.gov/3202884/
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2008.03886.x
https://link.sp
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