Autoantibodies and HLA class II DR-DQ genotypes in Ugandan children and adolescents with type 1 diabetes mellitus

  • Silver Bahendeka
  • Ronald Wesonga
  • Thereza Piloya Were
  • Catherine Nyangabyaki
Original Article
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Abstract

The aims were to determine the prevalence of autoantibodies in type 1 diabetes mellitus (T1DM) and further to investigate the human leukocyte antigen (HLA) class II DR-DQ genotypes associated with T1DM in Ugandan children and adolescents. Cross-sectional data were collected between January and December 2015 from 85 recently detected T1DM children and adolescents and 79 age-matched healthy controls. We measured serum concentrations of C-peptide, vitamin D, insulin autoantibodies (IAA), zinc transporter family member 8 antibodies (ZnT8-Ab), and glutamic acid decarboxylase autoantibodies (GADA). HLA-DBR1 and HLA-DQB1 typing was performed on EDTA-anticoagulated blood samples. The t test, chi-square test, and univariate logistic test were performed and multivariate logistic regression model fitted to identify associated factors of T1DM. Positive IAA and ZnT8-Ab were significantly higher in T1DM than in controls. GADA showed no difference between TIDM and controls. HLA-DQB1*02, unadjusted odds ratio (UOR) 4.2 (95% CI 1.4–12.7), and HLA-DBR1*04, adjusted odds ratio (AOR) 30.6 (95% CI 5.7–161.7), were significantly associated with T1DM. IAA and ZnT8-Ab are the likely significant positive antibodies in Ugandan children and adolescents with T1DM. The T1DM was associated with HLA-DQB1*02 and HLA-DBR1*04 (HLA-DR3 and HLA-DR4) genotypes.

Keywords

Type 1 diabetes Autoantibodies HLA class II Uganda 

Notes

Acknowledgements

We would like to acknowledge the contribution of Dr. William Omale, Arua Regional Hospital, for his assistance in organizing the type 1 diabetes clinic in Arua Regional Hospital, Uganda. We also like to thank MBN Clinical Laboratory and St. Francis Hospital, Nsambya, for the kind assistance in handling the laboratory samples and analysis. We thank the World Diabetes Foundation (WDF) and Novo Nordisk Changing Diabetes in Children (CDiC) for funding the type 1 diabetes clinics in Uganda. We wish to thank all the health workers and parents involved in the type 1 diabetes clinics in Uganda.

Authors contributions

All the authors, SKB, RW, TPW, and CN, contributed to the design, data collection, data analysis, and writing of the manuscript. All authors: read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study: children aged 8–17 years assented to participate, with parents of children below age of 18 years giving the informed consent. Participants above the age of 18 years were eligible and gave informed consent to participate.

Ethical approval

Ethical approval was obtained from St. Francis Hospital, Nsambya and Mulago Hospital Institutional Review Boards/Review Ethical Committees; both of which are accredited by the Uganda National Council of Science and Technology (UNCST). All procedures performed in this study were in accordance with the ethical standards of UNCST and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  • Silver Bahendeka
    • 1
    • 2
  • Ronald Wesonga
    • 3
  • Thereza Piloya Were
    • 4
  • Catherine Nyangabyaki
    • 2
  1. 1.Mother Kevin Postgraduate Medical School, Uganda Martyrs UniversityKampalaUganda
  2. 2.St. Francis HospitalKampalaUganda
  3. 3.School of Statistics and PlanningMakerere UniversityKampalaUganda
  4. 4.School of Medicine, College of Health SciencesMakerere UniversityKampalaUganda

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