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Hampe, C.S.* ; Sahabandu, D.* ; Kaiser, V.* ; Telieps, T. ; Smeeth, L.* ; Agyemang, C.* ; Spranger, J.* ; Schulze, M.B.* ; Mockenhaupt, F.P.* ; Danquah, I.* ; Rolandsson, O.*

Geographic location determines beta-cell autoimmunity among adult Ghanaians: Findings from the RODAM study.

Immun. Inflamm. Dis. 8, 299-309 (2020)

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Introduction: Beta-cell autoantibodies are established markers of autoimmunity, which we compared between Ghanaian adults with or without diabetes, living in rural and urban Ghana and in three European cities. Methods: In the multicenter cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study (N = 5898), we quantified autoantibodies against glutamic acid decarboxylase (GAD65Ab) by radioligand binding assay (RBA) and established cut-offs for positivity by displacement analysis. In a subsample, we performed RBA for zinc transporter-8 autoantibodies (ZnT8Ab). Associations of environmental, sociodemographic, and clinical factors with GAD65Ab were calculated. Results: In this study population (age: 46.1 ± 11.9 years; female: 62%; Ghana-rural: 1111; Ghana-urban: 1455; Europe: 3332), 9.2% had diabetes with adult-onset. GAD65Ab concentrations were the highest in Ghana-rural (32.4; 10.8-71.3 U/mL), followed by Ghana-urban (26.0; 12.3-49.1 U/mL) and Europe (11.9; 3.0-22.8 U/mL) with no differences between European cities. These distributions were similar for ZnT8Ab. Current fever, history of fever, and higher concentrations of liver enzymes marginally explained site-specific GAD65Ab concentrations. GAD65Ab positivity was as frequent in diabetes as in nondiabetes (5.4% vs 6.1%; P =.25). This was also true for ZnT8Ab positivity. Conclusion: Geographic location determines the occurrence of GAD65Ab and ZnT8Ab more than the diabetes status. Beta-cell autoimmunity may not be feasible to differentiate diabetes subgroups in this population.

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