Diabetes and cardiovascular risk research in previously disadvantaged communities

Professor Tandi Matsha’s career in research into diabetes and cardiovascular risk among mixed-ancestry communities in the Western Cape has changed the way that these non-communicable diseases are diagnosed and managed in South African communities.

She has chosen to study type 2 diabetes mellitus, because the burden of diabetes and associated cardiovascular risk in South Africa is enormous, is rapidly growing, and it disproportionately affects “previously disadvantaged” South Africans. Although the risk factors are largely due to the complex interaction between genetic, behavioural, and environmental factors, population-specific risk factors have not been clearly defined in populations from Africa. Furthermore, the known risk factors do not completely explain the sudden increase in diabetes in these populations, which is why Matsha’s research utilises an integrated approach encompassing epigenetics and transcriptome analysis to provide new mechanistic insights into the genesis of diabetes, and identify a panel of markers with diagnostic/prognostic and therapeutic relevance.

Matsha’s team was the first African research group to conduct genome-wide DNA methylation in diabetes and prediabetes, and these data clearly demonstrate that certain genes are differentially methylated in diabetes and prediabetes.

Recently, she and her team found simple methods to identify subjects at risk of developing full-blown diabetes or prediabetes, particularly in the mixed-ancestry population. This included demonstrating that the internationally recommended waist and waist-to-height threshold to diagnose obesity were inaccurate, and went on to derive and validate new cut-offs with improved diagnostic accuracy.

Formerly the head of the Cape Peninsula University of Technology’s (CPUT) Biomedical Sciences Department and founder of CPUT’s Cardiometabolic Health Research Unit, which she established, she is also the first recipient of a SARChi Research Chair in the Faculty of Health and Wellness Sciences.

Matsha’s research in the cardio-metabolic risk factors in subjects of mixed ancestry was the first such research in this population group since the 1990s, and revealed that international screening and assessment norms and standards were no longer accurate or adequate for this local population.

Through this work she has received wide recognition as a champion of cardiometabolic traits research in the mixed ancestry population of South Africa, and was awarded an NRF rating. She has since produced more than 100 articles in high impact journals such as The Lancet and Nature, with a consistent average of 10.5 journal articles published each year.

In her personal capacity, Matsha has supervised a number of postgraduate students, including staff members. By involving other staff members in her research, Matsha in turn empowered them to supervise other postgraduate students.

In addition to multiple accolades and awards, Matsha was recently asked to host an MRC Unit, which will allow her to take her research to higher levels and further encourage local and international collaboration.

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