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

Objective: Our primary aim was to clarify the blood lipid differences [Total serum cholesterol (TC), High-density lipoprotein (HDL), Low-density lipoprotein (LDL) and Triglyceride (TG)] between patients, who had attempted suicide and controls. Our secondary aim was to determine whether we could use the patients’ initial lipid profiles to predict suicide re-attempt within the subsequent year.

Methods: A total of 225 participants (110 attempted suicide patients and 115 normal controls) were recruited, with no differences in body mass index (BMI), age, and gender. Blood samples were collected from all participants for serum lipid profiles and assayed in an auto-analyzer. During a four-year follow-up, we divided the future suicide attempter group into suicide attempters in the subsequent year (SSY) and suicide attempters after the subsequent year (SASY).

Results: 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, 12.9; CI, 5.4 to 30.6) and low LDL/HDL (<1.8)(OR, 4.2; CI, 1.8 to 9.4) 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). An increased suicide attempt within the SSY in the low HDL group was demonstrated (Log Rank (Mantel-Cox) χ2=6.68; p=0.01).

Conclusion: Our study demonstrates that serum HDL level might be a potential candidate predictor for the future risk of suicidality among patients, who are admitted to the emergency department due to a suicide attempt.