Female attempted suicide patients with low HDL levels are at higher risk of suicide re-attempt within the subsequent year: A clinical cohort study

• This is the first study that has investigated the initial blood cholesterol levels of attempted suicide patients after their admittance to the ED, and compared them to those of controls. Also we examined the association between initial lipid levels and the risk of a future suicide attempt.
• Significant low HDL levels were observed in patients who re-attempted suicide within the subsequent year of follow-up.
• A low HDL level might serve as a biological marker in the assessment of suicide risk.

Our aims were, to clarify the blood lipid differences [Total serum cholesterol (TC), High-density lipoprotein (HDL), Low density lipoprotein (LDL), Triglyceride (TG)] between female patients who had attempted suicide and controls and to determine whether we could use the patients׳ initial lipid profiles to predict suicide re-attempt within the subsequent year. A total of 284 participants (110 cases and 174 controls) were recruited, with no differences in body mass index, age, blood sampling time and gender. Blood samples were collected from all participants for serum lipid profiles and assayed in an auto-analyzer. We divided the suicide re-attempter group into suicide attempters in the subsequent year (SSY) and suicide attempters after the subsequent year (SASY). The TC, LDL, and TG levels were significantly lower in the suicidal group than in the control group. HDL was significantly higher in the suicidal group than in the control group. Low TG (<70 mg/dL) (OR (odds ratio)=12.8; 95% CI (confidence interval)=5.4–30.5; p<0.0001)and low LDL/HDL (<1.8) (OR=4.1; 95% CI=1.8–9.3; p=0.001) were significantly associated with a current suicide attempt. HDL levels in the SSY (41.5±4.5 mg/dL) were lower than in the non-suicide attempters group (NSA) (50.9±10.3 mg/dL) and SASY (58.7±12.8 mg/dL)(d.f.=2, F=5.2, p=0.007). Serum HDL level may be a potential candidate predictor for the future risk of suicidality.