Biomarkers · Lipids & Apolipoproteins
Total Cholesterol
U-shaped: both low and high values carry risk. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation is associated with a hazard ratio of 0.91. U-shaped: slope not comparable
NHANES, our fit with 95% CIPublished curve
Hazard ratios relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
NHANES hazard per SD0.9195% CI 0.89–0.94 · 48,489 adults, 7,042 deaths
Published hazard ratio1.28top vs bottom quarter (95% CI 1.12–1.46) · NHANES I, II, and III Pooled Follow-up Cohorts
Across cohorts, HR per SD0.91NHANES 0.91 [0.89–0.94] · CRELES 0.79 [0.69–0.90]
Where people sit
Population percentiles (mg/dL) by sex and age band. Cycle or source as recorded in the catalogue.
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 126 | 154 | 178 | 204 | 248 | 2,690 | 2017-2018 |
| All | 40-59 | 136 | 169 | 196 | 224 | 272 | 2,640 | 2017-2018 |
| All | 60+ | 128 | 161 | 189 | 219 | 269 | 2,790 | 2017-2018 |
| All | all | 131 | 162 | 188 | 216 | 264 | 8,120 | 2017-2018 |
| Men | all | 128 | 159 | 184 | 212 | 258 | 3,940 | 2017-2018 |
| Women | all | 134 | 165 | 192 | 221 | 270 | 4,180 | 2017-2018 |
What studies found when this marker was changed
Effects on the biomarker reported in the cited studies. They describe what happened in those populations, not a recommendation for anyone. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Untreated primary hypothyroidism | +20% to +50% elevation via LDL receptor downregulation | clinical guideline | Garber JR, et al. Endocr Pract. 2012;18:988-1028. |
| diet | Dietary soluble viscous fiber (Beta-glucan / Psyllium 10-15g/day) | -5% to -12% reduction | meta-analysis | Brown L, et al. Am J Clin Nutr. 1999;69:30-42. |
| diet | High dietary saturated fat and industrial trans-fatty acids | +15% to +35% elevation | meta-analysis | Mensink RP, et al. Am J Clin Nutr. 2003;77:1146-1155. |
| nutraceutical | Plant sterols and stanols (2 g/day) | -8% to -14% reduction | meta-analysis | Plat J, et al. Atherosclerosis. 2019;288:149-160. |
| pharmacologic | HMG-CoA reductase inhibitors (Statins) | -25% to -45% reduction | meta-analysis | Baigent C, et al. Lancet. 2010;376:1670-1681. |
Sources
- Hazard curve: Recalculated from mortality_association (HR=1.28 quartile_extreme); per-SD log(HR)=0.1926.
- Boffetta P, et al. Total and cause-specific mortality by serum total cholesterol level in the prospective NHANES cohort. Ann Epidemiol. 2011;21(3):174-182.
- Empirical curve: our Cox model with age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Total Cholesterol against another biomarker · Featured: HDL × total cholesterol.