title: Islet cell-associated autoantibodies in Ethiopians with diabetes mellitus.
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: 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.
authors.forename: Elias S
authors.initials: ES
authors.lastname: Siraj
authors.affiliation: Cleveland Clinic, Department of Endocrinology, Diabetes & Metabolism, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Manjula K
authors.initials: MK
authors.lastname: Gupta
authors.affiliation: Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.
authors.forename: Helen
authors.initials: H
authors.lastname: Yifter
authors.affiliation: Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.
authors.forename: Abdurezak
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.
authors.forename: Tedla
authors.initials: T
authors.lastname: Kebede
authors.affiliation: Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Reja
authors.affiliation: Addis Ababa University, Endocrine Unit, PO Box 9086, Addis Ababa, Ethiopia.
authors.forename: Jemal
authors.initials: J
authors.lastname: Abdulkadir
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000276:immunology; D005002:Ethiopia; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D001323:Autoantibodies; C096322:ICA512 autoantibody; D007328:Insulin; D005968:Glutamate Decarboxylase
keywords: Africa; Ethiopia; GAD, ICA; Islet cell antibodies; Type 1 diabetes