Lipoprotein lipids and the prevalence of hyperlipidaemia in rural India

The prevalence of hyperlipidaemias has been inadequately studied in rural populations of developing countries. No significant data exist on the population levels of serum cholesterol, cholesterol subclasses or triglycerides in these countries.

We studied fasting blood samples of 300 apparently healthy adults (202 men and 98 women, age range 20-73 years) randomly selected from a larger sample of 3148 individuals during a comprehensive cardiovascular risk-factor survey in Rajasthan, India. Levels of serum total cholesterol, its subfractions [low-density-lipoprotein (LDL) cholesterol, very-low-density-lipoprotein cholesterol and high-density-lipoprotein (HDL) cholesterol] and triglycerides were measured and correlated with age and anthropometric data.

The mean +/- SD serum total-cholesterol levels were 4.39 +/- 1.0 mmol/l in men and 4.37 +/- 1.0 mmol/l in women, the mean LDL-cholesterol levels 2.51 +/- 1.0 mmol/l in men and 2.62 +/- 0.9 mmol/l in women, the mean HDL-cholesterol levels 1.15 +/- 0.4 mmol/l in both mean and women and the mean fasting serum triglyceride levels 1.63 +/- 0.6 mmol/l in men and 1.48 +/- 0.7 mmol/l in women. Age correlated positively with total-cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels in both men and women. Levels of the cholesterol subtypes did not differ between the sexes (P > 0.01), although triglyceride levels were significantly higher in men (P < 0.01). Lipoprotein lipids did not correlate significantly with height, weight, body-mass index or waist:hip ratio. When classified according to the recommendations of the US National Cholesterol Education Program for the determination of the prevalence of hyperlipidaemia, 43 individuals (14.3%; men 14.4% and women 14.3%) had borderline high cholesterol levels (5.20-6.18 mmol/l) and 24 (8%; men 7.9% and women 8.2%) had high cholesterol levels (> or = 6.21 mmol/l). Forty-five participants (15%) had borderline high LDL-cholesterol levels (3.36-4.11 mmol/l) and 20 (6.7%) had high LDL-cholesterol levels (> or = 4.14 mmol/l); low HDL-cholesterol levels (< 0.9 mmol/L) were found in 89 (29.7%). Eighteen participants (6%) had mild hypertriglyceridaemia (2.82-5.64 mmol/l) and two (0.7%) had severe hypertriglyceridaemia (> 5.64 mmol/l).

Total-cholesterol and LDL-cholesterol levels are low in a rural Indian population, although an atherogenic lipid profile is present in a significant proportion.