Low cholesterol and violent crime

Background: Community cohort studies and meta-analyses of randomized trials have shown a relation between low or lowered cholesterol and death by viol ence (homicide, suicide, accident); in primates, cholesterol reduction has been linked to increased behavioral acts of aggression (Kaplan J, Manuck S. The effects of fat and cholesterol on aggressive behaviour in monkeys. Psy chosom. Med 1990;52:226-7; Kaplan J, Shivery C, Fontenot D, Morgan T, Howel l S, Manuck S et al. Demonstration of an association among dietary choleste rol, central serotonergic activity, and social behaviour in monkeys. Psycho som. Med 1994;56:479-84.). In this study we test for the first time whether cholesterol level is related to commission of violent crimes against other s in a large community cohort. Methods: We merged one-time cholesterol measurements on 79,777 subjects enr olled in a health screening project in Varmland, Sweden with subsequent pol ice records for arrests for violent crimes in men and women aged 24-70 at e nrollment; and with information on covariates. We performed a nested case c ontrol comparison of cholesterol in violent criminals - defined as those wi th two or more crimes of violence against others - to cholesterol in nonoff enders matched on age, enrollment year, sex, education and alcohol, using v ariable-ratio matching, with a nonparametric sign test. Results: One hundred individuals met criteria for criminal violence. Low ch olesterol (below the median) was strongly associated with criminal violence in unadjusted analysis (Men: risk ratio 1.94, P = 0.002; all subjects risk ratio 2.32, P < 0.001). Age emerged as a strong confounder. Adjusting for covariates using a matching procedure, violent criminals had significantly lower cholesterol than others identical in age, sex, alcohol indices and ed ucation, using a nonparametric sign test (P = 0.012 all subjects; P = 0.035 men). Conclusions: Adjusting for other factors, low cholesterol is associated wit h increased subsequent criminal violence. (C) 2000 Elsevier Science Ltd, Al l rights reserved.