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J Diabetes Complications. 2016 Aug;30(6):1039-42. doi: 10.1016/j.jdiacomp.2016.05.005. Epub 2016 May 7.

Islet cell-associated autoantibodies in Ethiopians with diabetes mellitus.

Author information

1
Lewis Katz School of Medicine at Temple University, Section of Endocrinology, 3322North Broad St., Philadelphia, PA 19140, USA. Electronic address: elias.siraj@tuhs.temple.edu.
2
Cleveland Clinic, Department of Endocrinology, Diabetes & Metabolism, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
3
Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.

Abstract

BACKGROUND & AIMS:

Our understanding of the role of autoimmunity in the pathogenesis of diabetes in African populations is limited. This study aims to evaluate the prevalence of 4 different islet cell-associated antibodies in Ethiopian patients with diabetes and non-diabetic controls.

METHODS:

A total of 187 subjects from a diabetic clinic at an Ethiopian hospital were evaluated in a cross-sectional study. Fifty-five patients had type 1 diabetes mellitus (T1DM), 86 had type 2 diabetes mellitus (T2DM) and 46 were non-diabetic controls. Islet cell-associated antibodies were measured using 4 different assays for antibodies against islet cells (ICA), glutamic acid decarboxylase (GADA), insulin (IAA) and the protein tyrosine phosphatase-like IA-2 (IA-2A).

RESULTS:

Comparing the antibody positivity in subjects with T1DM versus T2DM, the results were as follows: 29% versus 3.5% for GADA; 21% versus 2.7% for ICA; 27% versus 16% for IAA. In the control group, the only positive result was for IAA at 2%. IA-2A was absent in all groups. The combi-assay for GADA and IA-2A detected all GADA-positive subjects. T2DM patients who were GADA positive had lower BMI, lower C-peptide levels and all of them were on insulin therapy.

CONCLUSIONS:

Compared to Caucasians, Ethiopians with T1DM have less prevalence of islet cell-associated antibodies, but the rates are higher than in T2DM. GADA is present in Ethiopians, whereas IA-2A seems to be absent. GADA positivity in T2DM correlates with clinical features of T1DM, indicating the existence in Ethiopia of the subgroup, latent autoimmune diabetes in adults.

KEYWORDS:

Africa; Ethiopia; GAD, ICA; Islet cell antibodies; Type 1 diabetes

PMID:
27220543
DOI:
10.1016/j.jdiacomp.2016.05.005
[Indexed for MEDLINE]

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