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Is interleukin-6 the link between low LDL cholesterol and increased non-cardiovascular mortality in the elderly?
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  • Published on:
    Increased mortality associated with low cholesterol does not reflect reverse causality, but causes it.
    • Uffe Ravnskov, MD, PhD, Independent iresearcher Magle Stora Kyrkogata 9, 22350, Lund
    • Other Contributors:
      • Kilmer S McCully, M D, Director
      • Paul J Rosch, Clinical Professor of Medicine and Psychiatry

    DiNicolantonio and McCarty suggest that the inverse association between low cholesterol and mortality in elderly people reflects reverse causality; meaning that the low cholesterol is caused by the disorder being treated.1 One of their arguments is that those whose cholesterol decreases with increasing age die more frequently from cancer and other diseases, compared to those with low cholesterol prior to treatment. However, many studies have shown that low cholesterol may predispose to cancer2 as well as infectious diseases.3 In a previous paper2 we identified nine cohort studies including more than 140,000 individuals, in which cancer was inversely associated with cholesterol measured 10–30 years earlier, and where the association persisted after exclusion of cancer cases appearing during the first 4 years.
    The authors claim that statin treatment does not increase the risk of cancer based on a meta-analysis of 27 randomised trials published by the Cholesterol Treatment Trialists’ (CTT) Collaborators. But very few statin trials have continued for more than five years, and most carcinogenic chemicals need more time to create cancer. In spite of that cancer appeared significantly more often in three statin trials (2). In two other trials, non-melanoma skin cancer appeared more often and with statistical significance if the figures from the two trials were calculated together (2). Since then the number of non-melanoma skin cancers has not been reported in any trial. Fu...

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    Conflict of Interest:
    None declared.