Which cholesterol level is related to the lowest mortality in a populationwith low mean cholesterol level: A 6.4-year follow-up study of 482,472 Korean men

To evaluate the relation between low cholesterol level and mortality, the a uthors 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 1 89.1 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 associat ed with increased risk of total mortality, even after eliminating deaths th at occurred in the first 5 years of follow-up. The risk of death from coron ary heart disease increased significantly in men with the highest cholester ol level (greater than or equal to 252 mg/100 ml). There were various relat ions between cholesterol level and cancer mortality by site. Mortality from liver and colon cancer was significantly associated with a very low choles terol level (<135 mg/100 ml) without any evidence of a preclinical choleste rol-lowering effect. With lengthening follow-up, the significant relation b etween a very low cholesterol level (<135 mg/100 ml) and mortality from sto mach and esophageal cancer disappeared. The cholesterol level related with the lowest mortality ranged from 211 to 251 mg/100 ml, which was higher tha n the mean cholesterol level of study subjects.