Serum Lipids and Modernization in Coastal and Highland Papua New Guinea

Previous studies in Melanesiansof Papua New Guinea have documented low serum cholesterolconcentrations with no age-related rise and a virtual absence of coronary heart disease. However, because of recent reports of the emergence of coronary heart disease in this population, serum lipid concentrations in adults aged ≥25 years in three coastal (n = 1,489) and three highland (n = 388) village communitiesat different stages of modernization were examined as part of a survey undertaken in 1991. Total cholesterolconcentrations were clearly higher than were levels recorded in earlier studies. Moreover, age-related increases in total cholesterol, low density lipoprotein cholesterol(LDL cholesterol), high density lipoprotein cholesterol(HDL cholesterol), and triglycerides (in women) were apparent. Mean total cholesterollevels in an urban community with a high risk of diabetes were similar to those observed in Australians, while HDL cholesterolconcentrations were lower. Total cholesteroland LDL cholesterollevels were higher in urban coastal and periurban highland subjects than in their rural counterparts. Prevalence of hypercholesterolemia (≥5.2 mmol/liter) varied from 16% in rural highlanders to 56% in urban coastal subjects. Sex, age, village, body mass index, fat distribution, glucose intolerance, physical activity, and an index of relative modernity all contributed to variations in cholesteroland triglyceride concentrations. These results show that Papua New Guineansare by no means protected from dyslipidemia and serve warning that, unless effective preventative strategies can be developed, this and similar rapidly developing populations can expect an increasing incidence of coronary heart disease.