Violent behavior associated with hypocholesterolemia due to a novel APOB gene mutation

Abstract

A 26-year-old male, the index patient, presented with persecutory delusions and suicidal behavior. He had 10 paternal male relatives in two prior generations. Five of them died by violent suicide and one, of the five, also committed a double homicide. The index patient was found to be hypocholesterolemic due to being heterozygous for a novel mutation of apolipoprotein B (apoB-29.4). His mother and paternal grandmother were normocholesterolemic, whereas a surviving paternal uncle was hypocholesterolemic and heterozygous for the apoB-29.4 mutation. This indicated that the index patient's father and paternal grandfather, both of which died by violent suicide, were obligate heterozygotes for the apoB-29.4 mutation and that the index patient inherited the mutation from his paternal grandfather. The odds ratio for the association between hypocholesterolemia and violent behavior in this family, where cholesterol status was known, was 16.9 (95% confidence interval 1.1-239.3). Therefore, our results support an inheritable relationship between violent behavior and hypocholesterolemia.

A Rare Mutation in The APOB Gene Associated with Neurological Manifestations in Familial Hypobetalipoproteinemia

“…This leads to damage to the dorsal root ganglia, spinocerebellar tracts, retina, and cerebellum similar to those observed in vitamin E deficient mammals. Vitamin E is essential for neurological function and is transported in plasma in association with the apoB-containing lipoproteins [21]. The retinal degeneration, again peculiar to ABL, is thought to be caused by combined deficiency of vitamins A and E [22].…”

Cholesterol in coronary heart disease and psychiatric disorders: Same or opposite effects on morbidity risk?

“…However, the price to pay for such a protection from CHD may be an increased risk of violence. In a family with FHBL, Edgar et al (2007) found a significant association between hypocholesterolemia and violent behavior. The odds ratio for the association was 16.9 (95% confidence interval 1.1-239.3).…”

Plasma apolipoprotein E and severity of suicidal behaviour

“…Upon examination, it was discovered that 5 out of 10 males of his relatives had committed violent suicide and one a double homicide. The father of the index patient and the paternal grandfather were both heterozygotic for the novel mutation and both displayed hypocholesterolemia, further supporting a heritable association between cholesterol metabolism, low cholesterol, and possible violent behavior and violent suicide (Edgar et al, 2007).…”