Predominance of DR3 in Somali children with type 1 diabetes in the twin cities, Minnesota

Muna Sunni, Janelle A. Noble, Liping Yu, Zahra Mahamed, Julie A. Lane, Abdirahman M. Dhunkal, Melena D. Bellin, Brandon Nathan, Jennifer Kyllo, M. Jennifer Abuzzahab, Peter A. Gottlieb, Sunanda Babu, Taylor Armstrong, Antoinette Moran

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Abstract

Background: Minnesota is home to the largest Somali population in USA, and pediatric diabetes teams are seeing increasing numbers of Somali children with diabetes. Objective: To assess the immune basis of diabetes in Somali children in the Twin Cities, Minnesota. Methods: A total of 31 Somali children ≤19 yr were treated for type 1 diabetes (T1D) at the University of Minnesota Masonic Children's Hospital and Children's Hospitals and Clinics of Minnesota underwent analysis of human leukocyte antigen (HLA) alleles (n = 30) and diabetes autoantibodies [glutamic acid decarboxylase (GAD65), islet antigen 2 (IA-2), zinc transporter 8 (ZnT8); n = 31]. HLA alleles were analyzed in 49 Somalis without diabetes (controls). Anti-transglutaminase autoantibodies (TGA) for celiac disease were also measured. Results: In Somali children with T1D aged 13.5 ± 5 yr (35% female, disease duration 6.5 ± 3.6 yr), the most common HLA allele was DRB1*03:01 (93%, compared with 45% of Somali controls), followed by DRB1*13:02 (27%). There was a relatively low frequency of DR4 (13%). Controls showed a similar pattern. All 31 participants were positive for at least one diabetes autoantibody. Insulin antibodies were positive in 84% (all were on insulin). Excluding insulin antibodies, 23 (74%) subjects tested positive for at least one other diabetes autoantibody; 32% had 1 autoantibody, 32% had 2 autoantibodies, and 10% had 3 autoantibodies. GAD65 autoantibodies were found in 56% of subjects, IA-2 in 29%, and ZnT8 in 26%. Four (13%) were TGA positive. Conclusion: The autoantibody and HLA profiles of Somali children with diabetes are consistent with autoimmune diabetes. Their HLA profile is unique with an exceptionally high prevalence of DRB1*03:01 allele and relative paucity of DR4 alleles compared with African Americans with T1D.

Original languageEnglish (US)
Pages (from-to)136-142
Number of pages7
JournalPediatric Diabetes
Volume18
Issue number2
DOIs
StatePublished - Mar 1 2017

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Type 1 Diabetes Mellitus
Autoantibodies
HLA Antigens
Alleles
Insulin Antibodies
Transglutaminases
Antigens
Glutamate Decarboxylase
Celiac Disease
African Americans
Insulin
Pediatrics

Keywords

  • Somali
  • T1D
  • diabetes autoimmunity
  • human leukocyte antigen

Cite this

Predominance of DR3 in Somali children with type 1 diabetes in the twin cities, Minnesota. / Sunni, Muna; Noble, Janelle A.; Yu, Liping; Mahamed, Zahra; Lane, Julie A.; Dhunkal, Abdirahman M.; Bellin, Melena D.; Nathan, Brandon; Kyllo, Jennifer; Abuzzahab, M. Jennifer; Gottlieb, Peter A.; Babu, Sunanda; Armstrong, Taylor; Moran, Antoinette.

In: Pediatric Diabetes, Vol. 18, No. 2, 01.03.2017, p. 136-142.

Research output: Contribution to journalArticle

Sunni, M, Noble, JA, Yu, L, Mahamed, Z, Lane, JA, Dhunkal, AM, Bellin, MD, Nathan, B, Kyllo, J, Abuzzahab, MJ, Gottlieb, PA, Babu, S, Armstrong, T & Moran, A 2017, 'Predominance of DR3 in Somali children with type 1 diabetes in the twin cities, Minnesota', Pediatric Diabetes, vol. 18, no. 2, pp. 136-142. https://doi.org/10.1111/pedi.12369
Sunni, Muna ; Noble, Janelle A. ; Yu, Liping ; Mahamed, Zahra ; Lane, Julie A. ; Dhunkal, Abdirahman M. ; Bellin, Melena D. ; Nathan, Brandon ; Kyllo, Jennifer ; Abuzzahab, M. Jennifer ; Gottlieb, Peter A. ; Babu, Sunanda ; Armstrong, Taylor ; Moran, Antoinette. / Predominance of DR3 in Somali children with type 1 diabetes in the twin cities, Minnesota. In: Pediatric Diabetes. 2017 ; Vol. 18, No. 2. pp. 136-142.
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abstract = "Background: Minnesota is home to the largest Somali population in USA, and pediatric diabetes teams are seeing increasing numbers of Somali children with diabetes. Objective: To assess the immune basis of diabetes in Somali children in the Twin Cities, Minnesota. Methods: A total of 31 Somali children ≤19 yr were treated for type 1 diabetes (T1D) at the University of Minnesota Masonic Children's Hospital and Children's Hospitals and Clinics of Minnesota underwent analysis of human leukocyte antigen (HLA) alleles (n = 30) and diabetes autoantibodies [glutamic acid decarboxylase (GAD65), islet antigen 2 (IA-2), zinc transporter 8 (ZnT8); n = 31]. HLA alleles were analyzed in 49 Somalis without diabetes (controls). Anti-transglutaminase autoantibodies (TGA) for celiac disease were also measured. Results: In Somali children with T1D aged 13.5 ± 5 yr (35{\%} female, disease duration 6.5 ± 3.6 yr), the most common HLA allele was DRB1*03:01 (93{\%}, compared with 45{\%} of Somali controls), followed by DRB1*13:02 (27{\%}). There was a relatively low frequency of DR4 (13{\%}). Controls showed a similar pattern. All 31 participants were positive for at least one diabetes autoantibody. Insulin antibodies were positive in 84{\%} (all were on insulin). Excluding insulin antibodies, 23 (74{\%}) subjects tested positive for at least one other diabetes autoantibody; 32{\%} had 1 autoantibody, 32{\%} had 2 autoantibodies, and 10{\%} had 3 autoantibodies. GAD65 autoantibodies were found in 56{\%} of subjects, IA-2 in 29{\%}, and ZnT8 in 26{\%}. Four (13{\%}) were TGA positive. Conclusion: The autoantibody and HLA profiles of Somali children with diabetes are consistent with autoimmune diabetes. Their HLA profile is unique with an exceptionally high prevalence of DRB1*03:01 allele and relative paucity of DR4 alleles compared with African Americans with T1D.",
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AU - Noble, Janelle A.

AU - Yu, Liping

AU - Mahamed, Zahra

AU - Lane, Julie A.

AU - Dhunkal, Abdirahman M.

AU - Bellin, Melena D.

AU - Nathan, Brandon

AU - Kyllo, Jennifer

AU - Abuzzahab, M. Jennifer

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N2 - Background: Minnesota is home to the largest Somali population in USA, and pediatric diabetes teams are seeing increasing numbers of Somali children with diabetes. Objective: To assess the immune basis of diabetes in Somali children in the Twin Cities, Minnesota. Methods: A total of 31 Somali children ≤19 yr were treated for type 1 diabetes (T1D) at the University of Minnesota Masonic Children's Hospital and Children's Hospitals and Clinics of Minnesota underwent analysis of human leukocyte antigen (HLA) alleles (n = 30) and diabetes autoantibodies [glutamic acid decarboxylase (GAD65), islet antigen 2 (IA-2), zinc transporter 8 (ZnT8); n = 31]. HLA alleles were analyzed in 49 Somalis without diabetes (controls). Anti-transglutaminase autoantibodies (TGA) for celiac disease were also measured. Results: In Somali children with T1D aged 13.5 ± 5 yr (35% female, disease duration 6.5 ± 3.6 yr), the most common HLA allele was DRB1*03:01 (93%, compared with 45% of Somali controls), followed by DRB1*13:02 (27%). There was a relatively low frequency of DR4 (13%). Controls showed a similar pattern. All 31 participants were positive for at least one diabetes autoantibody. Insulin antibodies were positive in 84% (all were on insulin). Excluding insulin antibodies, 23 (74%) subjects tested positive for at least one other diabetes autoantibody; 32% had 1 autoantibody, 32% had 2 autoantibodies, and 10% had 3 autoantibodies. GAD65 autoantibodies were found in 56% of subjects, IA-2 in 29%, and ZnT8 in 26%. Four (13%) were TGA positive. Conclusion: The autoantibody and HLA profiles of Somali children with diabetes are consistent with autoimmune diabetes. Their HLA profile is unique with an exceptionally high prevalence of DRB1*03:01 allele and relative paucity of DR4 alleles compared with African Americans with T1D.

AB - Background: Minnesota is home to the largest Somali population in USA, and pediatric diabetes teams are seeing increasing numbers of Somali children with diabetes. Objective: To assess the immune basis of diabetes in Somali children in the Twin Cities, Minnesota. Methods: A total of 31 Somali children ≤19 yr were treated for type 1 diabetes (T1D) at the University of Minnesota Masonic Children's Hospital and Children's Hospitals and Clinics of Minnesota underwent analysis of human leukocyte antigen (HLA) alleles (n = 30) and diabetes autoantibodies [glutamic acid decarboxylase (GAD65), islet antigen 2 (IA-2), zinc transporter 8 (ZnT8); n = 31]. HLA alleles were analyzed in 49 Somalis without diabetes (controls). Anti-transglutaminase autoantibodies (TGA) for celiac disease were also measured. Results: In Somali children with T1D aged 13.5 ± 5 yr (35% female, disease duration 6.5 ± 3.6 yr), the most common HLA allele was DRB1*03:01 (93%, compared with 45% of Somali controls), followed by DRB1*13:02 (27%). There was a relatively low frequency of DR4 (13%). Controls showed a similar pattern. All 31 participants were positive for at least one diabetes autoantibody. Insulin antibodies were positive in 84% (all were on insulin). Excluding insulin antibodies, 23 (74%) subjects tested positive for at least one other diabetes autoantibody; 32% had 1 autoantibody, 32% had 2 autoantibodies, and 10% had 3 autoantibodies. GAD65 autoantibodies were found in 56% of subjects, IA-2 in 29%, and ZnT8 in 26%. Four (13%) were TGA positive. Conclusion: The autoantibody and HLA profiles of Somali children with diabetes are consistent with autoimmune diabetes. Their HLA profile is unique with an exceptionally high prevalence of DRB1*03:01 allele and relative paucity of DR4 alleles compared with African Americans with T1D.

KW - Somali

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