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Comparative Study
. 2014 Jan;103(1):97-105.
doi: 10.1016/j.diabres.2013.11.013. Epub 2013 Nov 20.

Clinical and biological characteristics of diabetic patients under age 40 in Cameroon: relation to autoantibody status and comparison with Belgian patients

Milca Asanghanwa  1 , Frans K Gorus  2 , Ilse Weets  2 , Bart V der Auwera  1 , Folefac Aminkeng  3 , Eric Mbunwe  1 , Patrick Goubert  4 , Katrijn Verhaeghen  4 , Eugene Sobngwi  5 , Janet M Wenzlau  6 , John C Hutton  6 , Daniel G Pipeleers  1 , Bart Keymeulen  2 , Jean-Claude N Mbanya  5 , Chris van Schravendijk  7
Affiliations
Comparative Study

Clinical and biological characteristics of diabetic patients under age 40 in Cameroon: relation to autoantibody status and comparison with Belgian patients

Milca Asanghanwa et al. Diabetes Res Clin Pract. 2014 Jan.

Abstract

Aims: We investigated the prevalence of diabetes autoantibodies (Abs) in Cameroonian patients and controls, assessed their contribution in disease classification and compared results with data from Belgium.

Methods: Abs against GAD (GADA), IA-2 (IA-2A) and zinc transporter 8 (ZnT8A) were assessed in 302 recently diagnosed Cameroonian patients with diabetes and 184 control subjects without diabetes aged below 40 years.

Results: Only 27 (9%) Cameroonian patients were younger than 15 years. Overall, 29% of patients presented at least one diabetes-associated antibody vs 9% in healthy controls (24% vs 7% for GADA (p<0.001), 10% vs 3% for IA-2A (p<0.006), 4% vs 2% for ZnT8A). Ab(+) patients had lower C-peptide levels (p<0.001), were more often insulin-treated (p<0.002) and were as frequently diagnosed with type 1 diabetes as Ab(-) patients. Only 43% of Ab(+) patients aged 15-39 years were clinically classified as having type 1 diabetes in Cameroon vs 96% in Belgium (p<0.001). Not one Ab(+) Cameroonian patient carried HLA-DQ2/DQ8 genotype vs 23% of Belgian Ab(+) patients (p<0.001). Younger age at diagnosis and antibody positivity were independent predictors of insulin therapy. Ab(+) Cameroonian patients were older (p<0.001), had higher BMI (p<0.001) and lower Ab titers than Belgian Ab(+) patients. In ketonuric patients, prevalence of autoantibodies was similar as in non-ketonuric patients.

Conclusions: In Cameroonian patients with diabetes aged under 40 years, antibody-positivity is not clearly related to disease phenotype, but may help predict the need for insulin treatment.

Keywords: Autoantibodies; Classification; Diabetes; Sub-Saharan Africa.

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