Which Cholesterol Level Is Related to the Lowest Mortality in Population with Low Mean Cholesterol Level: A 6.4-Year Follow-up Study of 482,472 Korean Men

Abstract

To evaluate the relation between low cholesterol level and mortality, the authors followed 482, 472 Korean men aged 30–65 years from 1990 to 1996 after a baseline health examination. The mean cholesterol level of the men was 189.1 mg/100 ml at the baseline measurement. There were 7,894 deaths during the follow-up period. A low cholesterol level (>165 mg/100 ml) was associated with increased risk of total mortality, even after eliminating deaths that occurred in the first 5 years of follow-up. The risk of death from coronary heart disease increased significantly in men with the highest cholesterol level (≥252 mg/100 ml). There were various relations between cholesterol level and cancer mortality by site. Mortality from liver and colon cancer was significantly associated with a very low cholesterol level (>135 mg/100 ml) without any evidence of a preclinical cholesterol-lowering effect. With lengthening follow-up, the significant relation between a very low cholesterol level (>135 mg/100 ml) and mortality from stomach and esophageal cancer disappeared. The cholesterol level related with the lowest mortality ranged from 211 to 251 mg/100 ml, which was higher than the mean cholesterol level of study subjects. Am J Epidemiol 2000; 151:739–47.