Evaluating Polygenic Score Transferability for Lipid Traits in Underrepresented Populations: Evidence from Samoan Cohorts

Dyslipidemia is a significant risk factor for cardiovascular disease (CVD), the leading cause of death in Samoa, accounting for 34% of deaths. Polygenic scores (PGS) derived from large scale multi ancestry genome-wide association studies offer potential for improved CVD risk prediction by aggregating genetic effects on lipid traits, yet their performance in Pacific Islander populations remains largely unknown. We evaluated the transferability of multi-ancestry PGS for LDL cholesterol (LDL C), HDL cholesterol (HDL C), triglycerides (TG), and total cholesterol (TC) in 4,342 Samoan adults across five cohorts spanning 1990 to 2010. PGS derived from Graham et al. and Kanoni et al. multi-ancestry