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Meta-Analysis
. 2020 Jun 30:2020:3198671.
doi: 10.1155/2020/3198671. eCollection 2020.

Heritability and Genetics of Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Evans Adu Asamoah  1 , Christian Obirikorang  1 , Emmanuel Acheampong  1 , Max Efui Annani-Akollor  1 , Edwin Ferguson Laing  1 , Eddie-Williams Owiredu  1 , Enoch Odame Anto  1
Affiliations
Free PMC article
Meta-Analysis

Heritability and Genetics of Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Evans Adu Asamoah et al. J Diabetes Res. .
Free PMC article

Abstract

Objectives: Sub-Saharan Africa (SSA) is observing an accelerating prevalence rate of type 2 diabetes mellitus (T2DM) influenced by gene-environment interaction of modifiable and nonmodifiable factors. We conducted a systematic review and meta-analysis on the heritability and genetic risk of T2DM in SSA.

Methods: We reviewed all published articles on T2DM in SSA between January 2000 and December 2019 and available in PubMed, Scopus, and Web of Science. Studies that reported on the genetics and/or heritability of T2DM or indicators of glycaemia were included. Data extracted included the study design, records of family history, pattern and characteristics of inheritance, genetic determinants, and effects estimates.

Results: The pattern and characteristics of T2DM heritability in SSA are preference for maternal aggregation, higher among first degree compared to second-degree relatives; early age-onset (<50 years), and inherited abnormalities of beta-cell function/mass. The overall prevalence of T2DM was 28.2% for the population with a positive family history (PFH) and 11.2% for the population with negative family history (NFH). The pooled odds ratio of the impact of PFH on T2DM was 3.29 (95% CI: 2.40-4.52). Overall, 28 polymorphisms in 17 genes have been investigated in relation with T2DM in SSA. Almost all studies used the candidate gene approach with most (45.8%) of genetic studies published between 2011 and 2015. Polymorphisms in ABCC8, Haptoglobin, KCNJ11, ACDC, ENPP1, TNF-α, and TCF7L2 were found to be associated with T2DM, with overlapping effect on specific cardiometabolic traits. Genome-wide studies identified ancestry-specific signals (AGMO-rs73284431, VT11A-rs17746147, and ZRANB3) and TCF7L2-rs7903146 as the only transferable genetic risk variants to SSA population. TCF7L2-rs7903146 polymorphism was investigated in multiple studies with consistent effects and low-moderate statistical heterogeneity. Effect sizes were modestly strong [odds ratio = 6.17 (95% CI: 2.03-18.81), codominant model; 2.27 (95% CI: 1.50-3.44), additive model; 1.75 (95% CI: 1.18-2.59), recessive model]. Current evidence on the heritability and genetic markers of T2DM in SSA populations is limited and largely insufficient to reliably inform the genetic architecture of T2DM across SSA regions.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart for the study selection process.
Figure 2
Figure 2
Forest plots for meta-analysis of family history and the risk of T2DM among SSA population.
Figure 3
Figure 3
Leave-one-out sensitivity analysis of the effect of PFH on the risk of T2DM.
Figure 4
Figure 4
Funnel plots of studies reporting on family history and the risk of T2DM in SSA.
Figure 5
Figure 5
Forest plots for meta-analysis of the association between TCF7L2-rs7903146 and the risk of T2DM among the SSA population.
See this image and copyright information in PMC

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