Association of sickle cell trait with β‐cell dysfunction and physical activity in adults living with and without HIV in Tanzania

Kweka, Belinda; Fredrick, Cyprian; Kitilya, Brenda; Jeremiah, Kidola; Lyimo, Eric; Filteau, Suzanne; Rehman, Andrea M.; Friis, Henrik; Olsen, Mette Frahm; Faurholt‐Jepsen, Daniel; Krogh-Madsen, Rikke; PrayGod, George

doi:10.1111/apm.13214

Cited by 2 publications

(1 citation statement)

References 55 publications

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“…These studies need to consider traits most prevalent in SSA, for example, sickle cell disease, which is an inherited disorder characterised by structural changes in haemoglobin. While people with sickle cell trait (representing ~25% of the sub-Saharan African population) do not have symptoms of sickle cell disease, they are at higher risk of beta cell dysfunction, with the risk for type 2 diabetes exacerbated by anti-retroviral therapy (ART) [ 74 ].…”

Section: Factors That May Influence the Pathogenesis Of Type 2 Diabet...mentioning

confidence: 99%

Pathophysiology of type 2 diabetes in sub-Saharan Africans

Goedecke

Mendham

2022

Diabetologia

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Sub-Saharan Africa (SSA) is the region with the highest projected rates of increase in type 2 diabetes (129% by 2045), which will exacerbate the already high prevalence of type 2 diabetes complications and comorbidities in SSA. In addition, SSA is grappling with poverty-related health problems and infectious diseases and is also undergoing the most rapid rates of urbanisation globally. These socioenvironmental and lifestyle factors may interact with genetic factors to alter the pathophysiological sequence leading to type 2 diabetes in sub-Saharan African populations. Indeed, current evidence from SSA and the diaspora suggests that the pathophysiology of type 2 diabetes in Black Africans is different from that in their European counterparts. Studies from the diaspora suggest that insulin clearance is the primary defect underlying the development of type 2 diabetes. We propose that, among Black Africans from SSA, hyperinsulinaemia due to a combination of both increased insulin secretion and reduced hepatic insulin clearance is the primary defect, which promotes obesity and insulin resistance, exacerbating the hyperinsulinaemia and eventually leading to beta cell failure and type 2 diabetes. Nonetheless, the current understanding of the pathogenesis of type 2 diabetes and the clinical guidelines for preventing and managing the disease are largely based on studies including participants of predominately White European ancestry. In this review, we summarise the existing knowledge base and data from the only non-pharmacological intervention that explores the pathophysiology of type 2 diabetes in SSA. We also highlight factors that may influence the pathogenesis of type 2 diabetes in SSA, such as social determinants, infectious diseases and genetic and epigenetic influences. Graphical abstract

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Section: Factors That May Influence the Pathogenesis Of Type 2 Diabet...mentioning

confidence: 99%

Pathophysiology of type 2 diabetes in sub-Saharan Africans

Goedecke

Mendham

2022

Diabetologia

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Association of sickle cell trait with β‐cell dysfunction and physical activity in adults living with and without HIV in Tanzania

Kweka

Fredrick

Kitilya

et al. 2022

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This study aimed to investigate sickle cell trait (SCT) associations with physical activity, markers of insulin secretion and resistance, and glucose among people living with HIV infection (PLWH), both antiretroviral therapy (ART) naive and experienced, and HIV‐uninfected adults. This was a cross‐sectional study conducted in Mwanza, Northwestern Tanzania. We used data of 668 participants attained from two sub‐studies of CICADA study. Mean age was 40 (SD 11.5) years, 402 (61.7%) were females and 157 (24.1%) had SCT. PLWH were 422 (64.7%), of these, 80 (18.9%) were on ART. People with SCT had higher risk of having an isolated β‐cell dysfunction compared to those without SCT (RRR = 1.82, CI: 1.10, 3.01, p = 0.02). People with SCT but without HIV infection had lower average acceleration on the trunk longitudinal axis (ACCx) and higher level of self‐reported physical activity. 30 min oral glucose tolerance test among PLWH on ART was higher in those with SCT compared to those without SCT. People with SCT are at higher risk of having β‐cell dysfunction and those with SCT on ART are at more risk of developing diabetes. Future studies to investigate the interaction between SCT and HIV/ART on risk of diabetes should be considered.

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Association of sickle cell trait with β‐cell dysfunction and physical activity in adults living with and without HIV in Tanzania

Cited by 2 publications

References 55 publications

Pathophysiology of type 2 diabetes in sub-Saharan Africans

Pathophysiology of type 2 diabetes in sub-Saharan Africans

Association of sickle cell trait with β‐cell dysfunction and physical activity in adults living with and without HIV in Tanzania

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