title: High prevalence of polyclonal hypergamma-globulinemia in adult males in Ghana, Africa.
abstract: Chronic antigenic stimulation is associated with hypergamma-globulinemia. Higher rates of hypergamma-globulinemia in tropical populations are maintained even with migration to temperate regions. We conducted a population-based screening study to assess the prevalence and risk factors for hypergamma-globulinemia in Ghana, Africa. 917 Ghanaian males (50-74 years) underwent in-person interviews and health examinations. Serum from all persons was analyzed by electrophoresis performed on agarose gel; serum with a discrete/localized band was subjected to immunofixation. 54 persons with monoclonal proteins were excluded and 17 samples were insufficient for analysis. Using logistic regression and Chi-square statistics we analyzed patterns of hypergamma-globulinemia. Among 846 study subjects, the median γ-globulin level was 1.86 g/dL. On the basis of a U.S. reference, 616 (73%) had hypergamma-globulinemia (>1.6 g/dL) and 178 (21%) had γ-globulin levels >2.17 gm/dl. On multivariate analyses, lower education status (P = 0.0013) and never smoking (P = 0.038) were associated with increased γ-globulin levels. Self-reported history of syphilis was associated with hypergamma-globulinemia. We conclude that three quarters of this population-based adult Ghanaian male sample had hypergamma-globulinemia with γ-globulin levels >1.6 g/dL. Future studies are needed to uncover genetic and environmental underpinnings of our finding, and to define the relationship between hypergamma-globulinemia, monoclonal gammopathy of undetermined significance (MGUS), and multiple myeloma.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. Buadi.Francis@mayo.edu
authors.forename: Francis
authors.initials: F
authors.lastname: Buadi
authors.forename: Ann W
authors.initials: AW
authors.lastname: Hsing
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Katzmann
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: Adam
authors.initials: A
authors.lastname: Waxman
authors.forename: Edward D
authors.initials: ED
authors.lastname: Yeboah
authors.forename: Richard B
authors.initials: RB
authors.lastname: Biritwum
authors.forename: Yao
authors.initials: Y
authors.lastname: Tettey
authors.forename: Andrew
authors.initials: A
authors.lastname: Adjei
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Chu
authors.forename: Angelo
authors.initials: A
authors.lastname: DeMarzo
authors.forename: George J
authors.initials: GJ
authors.lastname: Netto
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D000328:Adult; D000368:Aged; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood* / Q000453:epidemiology*; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis
chemical_list: D007074:Immunoglobulin G