The idea that very low

Nutrition Health Review, Summer, 2006

THE IDEA THAT VERY LOW cholesterol levels might be linked to an increased risk of cancer seems counterintuitive. Researchers from Tufts University School of Medicine in Boston conducted a meta-analysis of more than 75,000 patients who were taking statin medications for lowering cholesterol levels. They assessed the relationship between reducing low-density lipoprotein-cholesterol (LDL-C) levels and elevated liver.enzymes plus rhabdomyolysis, which are adverse events that can result from taking statins. Rhabdomyolysis is a relatively uncommon painful condition in which skeletal muscle is broken down and muscle enzymes and electrolytes are released from inside muscle cells.

Researchers observed a disturbing inverse relationship between the newly achieved LDL-C levels and the risk of newly diagnosed cancer. Cancer rates were linked to how low cholesterol levels became, not to how much they declined. They cautioned that their observation was only hypothetical, that their results did not prove a cause-and-effect relationship, and that it did not contradict the evidence that statins were still considered the "gold standard" in the effort to prevent heart disease.

The evidence amassed from large-scale clinical studies has confirmed that statins themselves were not associated with an increased risk of cancer compared with placebo. The investigators were asking this question: What is the relationship between cancer and reducing LDL-C levels in patients treated with statins? This question is especially pertinent in today's era of "lower is better." The team explained that the increase in cancer deaths in epidemiological studies appeared to cancel the lower cardiac mortality associated with lower cholesterol. They suggested that low cholesterol levels might be the result of, rather than the cause of, cancer and that the cancer had been present before it was diagnosed.

(Source: Journal of the American College of Cardiology, 2007; 50:409-418.)