title: Clinical and biological characteristics of diabetic patients under age 40 in Cameroon: relation to autoantibody status and comparison with Belgian patients.
abstract: OBJECTIVE
  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.
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium.
authors: Milca
authors: M
authors: Asanghanwa
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium; Department of Clinical Chemistry and Radio-immunology, University Hospital Brussels Free University - UZ Brussel, Brussels, Belgium.
authors: Frans K
authors: FK
authors: Gorus
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium; Department of Clinical Chemistry and Radio-immunology, University Hospital Brussels Free University - UZ Brussel, Brussels, Belgium.
authors: Ilse
authors: I
authors: Weets
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium.
authors: Bart V
authors: BV
authors: der Auwera
authors: The Canadian Pharmacogenomics Network for Drug Safety, University of British Columbia, Canada.
authors: Folefac
authors: F
authors: Aminkeng
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium.
authors: Eric
authors: E
authors: Mbunwe
authors: Department of Clinical Chemistry and Radio-immunology, University Hospital Brussels Free University - UZ Brussel, Brussels, Belgium.
authors: Patrick
authors: P
authors: Goubert
authors: Department of Clinical Chemistry and Radio-immunology, University Hospital Brussels Free University - UZ Brussel, Brussels, Belgium.
authors: Katrijn
authors: K
authors: Verhaeghen
authors: Faculty of Medicine and Biomedical Sciences, Department of Medicine and Specialties, Laboratory for Molecular and Metabolic Medicine, The Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.
authors: Eugene
authors: E
authors: Sobngwi
authors: Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver, Aurora, CO, United States.
authors: Janet M
authors: JM
authors: Wenzlau
authors: Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver, Aurora, CO, United States.
authors: John C
authors: JC
authors: Hutton
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium.
authors: Daniel G
authors: DG
authors: Pipeleers
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium; Department of Clinical Chemistry and Radio-immunology, University Hospital Brussels Free University - UZ Brussel, Brussels, Belgium.
authors: Bart
authors: B
authors: Keymeulen
authors: Faculty of Medicine and Biomedical Sciences, Department of Medicine and Specialties, Laboratory for Molecular and Metabolic Medicine, The Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon.
authors: Jean-Claude N
authors: JC
authors: Mbanya
authors: Diabetes Research Center, Brussels Free University - VUB, Laarbeeklaan 103, B-1090 Brussels, Belgium. Electronic address: chrisvs@vub.ac.be.
authors: Chris
authors: C
authors: van Schravendijk
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001530:Belgium / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood*; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D027682:Cation Transport Proteins / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8 / Q000276:immunology*; D055815:Young Adult; D000075703:Zinc Transporter 8
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D027682:Cation Transport Proteins; C492522:SLC30A8 protein, human; D000075703:Zinc Transporter 8; C516862:PTPRN protein, human; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8; D005968:Glutamate Decarboxylase
keywords: Autoantibodies; Classification; Diabetes; Sub-Saharan Africa