Study profile: the Durban Diabetes Study (DDS): a platform for chronic disease research

Hird, Thomas R; Eun, Young; Pirie, FJ; Riha, Johanna; Esterhuizen, TM; O’Leary, Brian; McCarthy, Mark I.; Sandhu, Manjinder S.; Motala, Ayesha A.

doi:10.1017/gheg.2015.3

Cited by 22 publications

(29 citation statements)

References 17 publications

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“…South African Zulu individuals were type 2 diabetes cases and controls from two studies: the Durban Diabetes Study (DDS) and the Durban Diabetes Case Control study (DCC). DDS was a population-based cross-sectional study of non-pregnant urban black African adults of Zulu descent, aged >18 years, residing in Durban, South Africa [ 15 , 16 ]. Further details are provided in the electronic supplementary material (ESM) Methods.…”

Section: Methodsmentioning

confidence: 99%

“…Additional type 2 diabetes cases from the same ethnic group and locality were obtained from the DCC, which included individuals with type 2 diabetes attending a diabetes clinic. Type 2 diabetes was defined using WHO criteria [ 15 , 16 ]. The combined type 2 diabetes cases and controls from DDS and DCC were aggregated into a single Zulu study.…”

Section: Methodsmentioning

confidence: 99%

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Genome-wide association study of type 2 diabetes in Africa

et al. 2019

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Aims/hypothesis Genome-wide association studies (GWAS) for type 2 diabetes have uncovered >400 risk loci, primarily in populations of European and Asian ancestry. Here, we aimed to discover additional type 2 diabetes risk loci (including African-specific variants) and fine-map association signals by performing genetic analysis in African populations. Methods We conducted two type 2 diabetes genome-wide association studies in 4347 Africans from South Africa, Nigeria, Ghana and Kenya and meta-analysed both studies together. Likely causal variants were identified using fine-mapping approaches. Results The most significantly associated variants mapped to the widely replicated type 2 diabetes risk locus near TCF7L2 ( p = 5.3 × 10 −13 ). Fine-mapping of the TCF7L2 locus suggested one type 2 diabetes association signal shared between Europeans and Africans (indexed by rs7903146) and a distinct African-specific signal (indexed by rs17746147). We also detected one novel signal, rs73284431, near AGMO ( p = 5.2 × 10 −9 , minor allele frequency [MAF] = 0.095; monomorphic in most non-African populations), distinct from previously reported signals in the region. In analyses focused on 100 published type 2 diabetes risk loci, we identified 21 with shared causal variants in African and non-African populations. Conclusions/interpretation These results demonstrate the value of performing GWAS in Africans, provide a resource to larger consortia for further discovery and fine-mapping and indicate that additional large-scale efforts in Africa are warranted to gain further insight in to the genetic architecture of type 2 diabetes. Electronic supplementary material The online version of this article (10.1007/s00125-019-4880-7) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Genome-wide association study of type 2 diabetes in Africa

et al. 2019

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“…As part of the ongoing collaborative work of the African Partnership for Chronic Disease Research, individual participant data (IPD) from 10 large-scale adult population surveys were collated for the purpose of these analyses. These surveys were conducted in nine countries: Democratic Republic of Congo (DRC), [16] Guinea, [17] Kenya, [18] Liberia, [19] Seychelles, [20] South Africa, [21] United Republic of Tanzania (consisting of Tanzania and Zanzibar), [22,23] Togo, [24] and Uganda [25]. All studies utilised or were consistent with the WHO STEPwise approach to noncommunicable disease risk factor surveillance tool (STEPS), which includes the Global Physical Activity Questionnaire (GPAQ) [26].…”

Section: Survey Methodsmentioning

confidence: 99%

“…All studies utilised or were consistent with the WHO STEPwise approach to noncommunicable disease risk factor surveillance tool (STEPS), which includes the Global Physical Activity Questionnaire (GPAQ) [26]. The methods of each survey are described in greater detail elsewhere [16,17,[19][20][21][22][23][24][25]27]. Each study employed a multi-level sampling strategy ( Supplementary Table S1), and was designed to be representative of the national or subnational populations from which they were drawn.…”

Section: Survey Methodsmentioning

confidence: 99%

Sociodemographic inequities associated with participation in leisure-time physical activity in sub-Saharan Africa: an individual participant data meta-analysis

et al. 2020

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Background: Leisure-time physical activity (LTPA) is an important contributor to total physical activity and the focus of many interventions promoting activity in high-income populations. Little is known about LTPA in sub-Saharan Africa (SSA), and with expected declines in physical activity due to rapid urbanisation and lifestyle changes we aimed to assess the sociodemographic differences in the prevalence of LTPA in the adult populations of this region to identify potential barriers for equitable participation. Methods: A two-step individual participant data meta-analysis was conducted using data collected in SSA through 10 population health surveys that included the Global Physical Activity Questionnaire. For each sociodemographic characteristic, the pooled adjusted prevalence and risk ratios (RRs) for participation in LTPA were calculated using the random effects method. Between-study heterogeneity was explored through meta-regression analyses and tests for interaction. Results: Across the 10 populations (N = 26,022), 18.9% (95%CI: 14.3, 24.1; I 2 = 99.0%) of adults (≥ 18 years) participated in LTPA. Men were more likely to participate in LTPA compared with women (RR for women: 0.43; 95%CI: 0.32, 0.60; P < 0.001; I 2 = 97.5%), while age was inversely associated with participation. Higher levels of education were associated with increased LTPA participation (RR: 1.30; 95%CI: 1.09, 1.55; P = 0.004; I 2 = 98.1%), with those living in rural areas or self-employed less likely to participate in LTPA. These associations remained after adjusting for time spent physically active at work or through active travel. Conclusions: In these populations, participation in LTPA was low, and strongly associated with sex, age, education, self-employment and urban residence. Identifying the potential barriers that reduce participation in these groups is necessary to enable equitable access to the health and social benefits associated with LTPA.

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“…A detailed description of the survey design and procedures has been previously published [13]. Written informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Burden of Diabetes and First Evidence for the Utility of HbA1c for Diagnosis and Detection of Diabetes in Urban Black South Africans: The Durban Diabetes Study

et al. 2016

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ObjectiveGlycated haemoglobin (HbA1c) is recommended as an additional tool to glucose-based measures (fasting plasma glucose [FPG] and 2-hour plasma glucose [2PG] during oral glucose tolerance test [OGTT]) for the diagnosis of diabetes; however, its use in sub-Saharan African populations is not established. We assessed prevalence estimates and the diagnosis and detection of diabetes based on OGTT, FPG, and HbA1c in an urban black South African population.Research Design and MethodsWe conducted a population-based cross-sectional survey using multistage cluster sampling of adults aged ≥18 years in Durban (eThekwini municipality), KwaZulu-Natal. All participants had a 75-g OGTT and HbA1c measurements. Receiver operating characteristic (ROC) analysis was used to assess the overall diagnostic accuracy of HbA1c, using OGTT as the reference, and to determine optimal HbA1c cut-offs.ResultsAmong 1190 participants (851 women, 92.6% response rate), the age-standardised prevalence of diabetes was 12.9% based on OGTT, 11.9% based on FPG, and 13.1% based on HbA1c. In participants without a previous history of diabetes (n = 1077), using OGTT as the reference, an HbA1c ≥48 mmol/mol (6.5%) detected diabetes with 70.3% sensitivity (95%CI 52.7–87.8) and 98.7% specificity (95%CI 97.9–99.4) (AUC 0.94 [95%CI 0.89–1.00]). Additional analyses suggested the optimal HbA1c cut-off for detection of diabetes in this population was 42 mmol/mol (6.0%) (sensitivity 89.2% [95%CI 78.6–99.8], specificity 92.0% [95%CI: 90.3–93.7]).ConclusionsIn an urban black South African population, we found a high prevalence of diabetes and provide the first evidence for the utility of HbA1c for the diagnosis and detection of diabetes in black Africans in sub-Saharan Africa.

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Study profile: the Durban Diabetes Study (DDS): a platform for chronic disease research

Cited by 22 publications

References 17 publications

Genome-wide association study of type 2 diabetes in Africa

Genome-wide association study of type 2 diabetes in Africa

Sociodemographic inequities associated with participation in leisure-time physical activity in sub-Saharan Africa: an individual participant data meta-analysis

Burden of Diabetes and First Evidence for the Utility of HbA1c for Diagnosis and Detection of Diabetes in Urban Black South Africans: The Durban Diabetes Study

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