SERUM-LIPIDS AND MODERNIZATION IN COASTAL AND HIGHLAND PAPUA-NEW-GUINEA

Previous studies in Melanesians of Papua New Guinea have documented lo w serum cholesterol concentrations with no age-related rise and a virt ual absence of coronary heart disease. However, because of recent repo rts of the emergence of coronary heart disease in this population, ser um lipid concentrations in adults aged greater than or equal to 25 yea rs in three coastal (n = 1,489) and three highland (n = 388) village c ommunities at different stages of modernization were examined as part of a survey undertaken in 1991. Total cholesterol concentrations were clearly higher than were levels recorded in earlier studies. Moreover, age-related increases in total cholesterol, low density lipoprotein c holesterol (LDL cholesterol), high density lipoprotein cholesterol (HD L cholesterol), and triglycerides (in women) were apparent. Mean total cholesterol levels in an urban community with a high risk of diabetes were similar to those observed in Australians, while HDL cholesterol concentrations were lower. Total cholesterol and LDL cholesterol level s were higher in urban coastal and periurban highland subjects than in their rural counterparts. Prevalence of hypercholesterolemia (greater than or equal to 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 inde x of relative modernity all contributed to variations in cholesterol a nd triglyceride concentrations. These results show that Papua New Guin eans are by no means protected from dyslipidemia and serve warning tha t, unless effective preventative strategies can be developed, this and similar rapidly developing populations can expect an increasing incid ence of coronary heart disease.