Evaluation of the Validity of Cholesterol as a Biomarker for Suicide in Veterans


Name: Charles Reuter

Rank: CPT

Organization: Rutgers University

Performance Site: Coatesville Veterans Affairs Medical Center, Coatesville, PA; Rutgers University, Camden, NJ

Year Published: 2015

Abstract Status: Project Completed


Previous research has indicated that cholesterol may be a valid biomarker for suicide. Serum cholesterol levels below 160 mg/dl decreases the brain cell membrane cholesterol, lowers the lipid microviscosity, and reduces the the availability of serotonin receptors on the membrane surface. This results in reduced serotonin uptake into brain cells, and may increase self-directed aggression and suicide in susceptible individuals.

Research will take place at Coatesville VAMC. Data on veterans who have been admitted for suicide ideation, suicide attempt, and veterans who have completed suicide between 2009 and 2014 will collected (population N = 375). Once a veteran has been identified in the suicide prevention coordinator's database, all visits to the facility will be collected. The foremost variable is the cholesterol level and whether admission was the result of an ideation, attempt, or a completed suicide. Additional data will include but not limited to the method intended or used for the suicide, diagnoses and medications.

The main objective is to determine if cholesterol below 160 mg/dl correlates with a higher likelihood of suicide ideation, attempt, or completion. Additional objectives include whether cholesterol is a stronger predictor than depression, is there a difference between naturally lowered or chemically lowered cholesterol, and if there is a correlation between cholesterol level and the lethality of the event. 

The proposed research design is a retrospective review of existing data in the VAMC Computerized Patient Record System (CPRS). The onsite suicide prevention coordinators maintain a database which tracks all suicide ideations, suicide attempts, and completed suicides for Coatesville VAMC. All veterans in this dataset will be retrieved followed by the extraction of the medical data from CPRS system. Once all data is collected, the statistical methods appropriate for each method of analysis will be performed; such as one-way ANOVA, Cox regression analysis (proportional hazard model), multivariate logistic regression, Chi-square, and repeated measures ANOVA. This research has the potential to save lives of veterans.

The research may produce evidence that supports the use of cholesterol as an additional screening tool for providers. No research has been found that explores this approach in a military or veteran sample. While there are many factors that must be considered when evaluating a veteran for potential risk of suicide, the addition of one easy to interpret lab value can be invaluable to the clinician. This research has the potential of saving the lives of veterans suffering from emotional and psychological impairments. 


Final Report available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2017102...