Mean lipid levels in refugees from Burma upon initial domestic medical examination, with age- and sex-adjusted comparison to non-refugee individuals in Burma

Abstract

Background: Studies have shown that cardiovascular disease risk factors are common in resettled refugees from Southeast Asia. It is possible that this is due to acclimation to Western lifestyle, but this hypothesis has not been tried by either comparison to a similar non-Western population or by baseline measurements of risk factors prior to Westernization. Furthermore, there has not been a study that has included refugees from Burma, the country with the largest number of refugees to resettle in the United States over the past decade. This study investigated the prevalence of cardiovascular risk factors, specifically hyperlipidemia, among refugees from Burma upon resettlement in the United States, with comparison to non-refugees living in Burma. Methods: This observational study included a refugee cohort of adult refugees from Burma who presented to Bethesda Clinic in St. Paul, Minnesota for initial refugee screening between November 2012 and March 2017 (n = 127). The refugees underwent medical examination in accordance with the Centers for Disease Control, with the addition of fasting lipid measurements. The low-density lipoprotein (LDL) cholesterol of the refugee cohort was compared to a non-refugee cohort surveyed in a nationwide sampling of Burma conducted by the World Health Organization in 2014. Results: Within the refugee cohort, the mean fasting LDL was 119 mg/dL. When adjusted for sex and age-group, the refugee cohort’s LDL was 19 mg/dL higher than the non-refugee cohort (95% CI 10 – 27 mg/dL, p <0.001). 15% to 17% of the refugees met criteria for statin therapy for primary prevention of cardiovascular disease, including 35% to 41% of those age 40 to 75 years. Conclusion: This study found a higher fasting LDL among refugees from Burma compared to non-refugees in Burma. This effect was present on initial domestic medical examination.