Publications by authors named "Ayesha Motala"

Background: There has been a notable shift towards the diagnosis of less severe and asymptomatic primary hyperparathyroidism (PHPT) in developed countries. However, there is a paucity of recent data from sub-Saharan Africa (SSA), and also, no reported data from SSA on the utility of intra-operative parathyroid hormone (IO-PTH) monitoring. In an earlier study from Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa (2003-2009), majority of patients (92.

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  • Type 2 diabetes (T2D) is a complex disease influenced by various genetic factors and molecular mechanisms that vary by cell type and ancestry.
  • In a large study involving over 2.5 million individuals, researchers identified 1,289 significant genetic associations linked to T2D, including 145 new loci not previously reported.
  • The study categorized T2D signals into eight distinct clusters based on their connections to cardiometabolic traits and showed that these genetic profiles are linked to vascular complications, emphasizing the role of obesity-related processes across different ancestry groups.
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  • Precision medicine can enhance the prediction of cardiovascular disease (CVD) risk in individuals with Type 2 diabetes (T2D), based on a systematic review of various studies.
  • Out of 9380 studies, 416 met criteria, focusing on biomarkers, genetic markers, and risk score/models to find new prognostic factors.
  • Only 13 biomarkers improved prediction, with NT-proBNP showing the strongest evidence, while other markers like troponin-T and triglyceride-glucose also showed moderate promise, highlighting a need for further research in this area.
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  • Precision medicine is an evolving approach in healthcare that aims to enhance decision-making and health outcomes, particularly in managing diabetes, which poses serious health risks for millions globally.
  • The second international consensus report on precision diabetes medicine reviews current findings on prevention, diagnosis, treatment, and prognosis across different forms of diabetes, highlighting the potential for translating research into clinical practice.
  • The report also identifies knowledge gaps and sets out key milestones for better clinical implementation, emphasizing the need for standards addressing cost-effectiveness, health equity, and accessibility in treatment options.
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HIV-1 remains a global health crisis, highlighting the need to identify new targets for therapies. Here, given the disproportionate HIV-1 burden and marked human genome diversity in Africa, we assessed the genetic determinants of control of set-point viral load in 3,879 people of African ancestries living with HIV-1 participating in the international collaboration for the genomics of HIV. We identify a previously undescribed association signal on chromosome 1 where the peak variant associates with an approximately 0.

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  • The study reviews the potential of precision medicine to enhance cardiovascular disease risk prediction in people with type 2 diabetes by analyzing long-term research studies.
  • Out of 9380 studies, only 416 met the criteria for inclusion, with a focus on biomarkers, genetic markers, and risk models; 13 showed significant improvement in prediction.
  • The most effective predictors identified were NT-proBNP, troponin-T, TyG index, and Genetic Risk Score for Coronary Heart Disease, although the overall findings indicate a need for more rigorous research to establish practical clinical applications.
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Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes. To characterise the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study (GWAS) data from 2,535,601 individuals (39.7% non-European ancestry), including 428,452 T2D cases.

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Background: Liver disease is any condition that causes liver damage and inflammation and may likely affect the function of the liver. Vital biochemical screening tools that can be used to evaluate the health of the liver and help diagnose, prevent, monitor, and control the development of liver disease are known as liver function tests (LFT). LFTs are performed to estimate the level of liver biomarkers in the blood.

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The poor transferability of genetic risk scores (GRSs) derived from European ancestry data in diverse populations is a cause of concern. We set out to evaluate whether GRSs derived from data of African American individuals and multiancestry data perform better in sub-Saharan Africa (SSA) compared to European ancestry-derived scores. Using summary statistics from the Million Veteran Program (MVP), we showed that GRSs derived from data of African American individuals enhance polygenic prediction of lipid traits in SSA compared to European and multiancestry scores.

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We assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent) through the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. Multi-ancestry GWAS meta-analysis identified 237 loci attaining stringent genome-wide significance (P < 5 × 10), which were delineated to 338 distinct association signals.

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Background And Aims: Obesity is one of the leading causes of non-communicable diseases (NCD). Thus, NCD risk varies in obese individuals based on the location of their fat depots; while subcutaneous adiposity is protective, visceral adiposity increases NCD risk. Although, previously anthropometric traits have been used to quantify body shape in low-income settings, there is no consensus on how it should be assessed.

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With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals.

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Objective: Polygenic prediction of type 2 diabetes (T2D) in continental Africans is adversely affected by the limited number of genome-wide association studies (GWAS) of T2D from Africa and the poor transferability of European-derived polygenic risk scores (PRSs) in diverse ethnicities. We set out to evaluate if African American, European, or multiethnic-derived PRSs would improve polygenic prediction in continental Africans.

Research Design And Methods: Using the PRSice software, ethnic-specific PRSs were computed with weights from the T2D GWAS multiancestry meta-analysis of 228,499 case and 1,178,783 control subjects.

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Article Synopsis
  • Type 2 diabetes mellitus (T2DM) is becoming more common in sub-Saharan Africa (SSA) as the region transitions from communicable to non-communicable diseases due to rapid urbanization.
  • Although there's increased awareness of T2DM, inconsistencies in research methods and a lack of high-quality studies make it hard to compare data across different regions.
  • The prevalence of T2DM is rising, especially in urban areas, but many remain undiagnosed; there's a pressing need for better funding and coordination in national health programs to address the growing issue of T2DM and its complications.
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Background: HIV clinical care programs in high burden settings are uniquely positioned to facilitate diabetes diagnosis, which is a major challenge. However, in sub-Saharan Africa, data on the burden of diabetes among people living with HIV (PLHIV) and its impact on HIV outcomes is sparse.

Methods: We enrolled adults presenting for HIV testing at an outpatient clinic in Durban.

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Objective: South Africa has a high burden of HIV infection and anaemia. These conditions may cause HbA to over- or underestimate glycaemia; however, this has not been comprehensively investigated in African populations. We assessed the association of anaemia, HIV infection and antiretroviral therapy (ART) with HbA , and implications for the detection and diagnosis of diabetes, in a black South African population.

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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.

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Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]≥140/90 mmHg/BP≥130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries.

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Genomic studies in African populations provide unique opportunities to understand disease etiology, human diversity, and population history. In the largest study of its kind, comprising genome-wide data from 6,400 individuals and whole-genome sequences from 1,978 individuals from rural Uganda, we find evidence of geographically correlated fine-scale population substructure. Historically, the ancestry of modern Ugandans was best represented by a mixture of ancient East African pastoralists.

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Article Synopsis
  • The study explored how a progressive resistance training (PRT) program and whey protein affect muscle strength in HIV-infected individuals on antiretroviral therapy.
  • Participants engaged in PRT twice weekly for 12 weeks and were given either whey protein or a placebo, with a follow-up phase to assess strength changes post-training.
  • Results showed that PRT significantly improved maximal strength across various exercises, and after a 12-week period without training, there was only slight strength loss, highlighting the program's effectiveness for this group.
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Aims: To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.

Methods: A total of 255 high-quality data sources, published between 1990 and 2018 and representing 138 countries were identified. For countries without high quality in-country data, estimates were extrapolated from similar countries matched by economy, ethnicity, geography and language.

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Aim: The study aimed to assess the prevalence of hypoglycaemia in subjects with type 1 diabetes (T1D) attending a public health tertiary diabetes clinic in Durban, South Africa.

Methods: Patients with T1D were enrolled at the time of clinic attendance. Data on hypoglycaemia over the previous 12 weeks were obtained from glucose meter downloads as well as diary records.

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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.

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There is a dearth of data on the burden and spectrum of non-alcoholic fatty liver disease (NAFLD) in African populations. The limited available information suggests that the prevalence of NAFLD in the general population is lowest for the Africa region. However, this is likely to be an underestimate and also does not take into consideration the long-term impact of rising rates of obesity, type-2 diabetes mellitus (T2DM) and high human immunodeficiency virus infection burden in Africa.

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