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Article History

Received: 1 May 2025

Accepted: 12 February 2026

First Online: 24 April 2026

Acknowledgements

: The authors are grateful to the participants, research nurses, interviewers, research assistants and other staff of the AADM and RODAM studies. The authors are very grateful to Dr Erik Beune (Department of Public Health, Academic Medical Center, Amsterdam, the Netherlands) who with great dedication and an eye for detail coordinated the RODAM study. This work used the computational resources of the NIH HPC Biowulf cluster ( ). The contributions of the NIH authors are considered Works of the United States Government. The findings and conclusions presented in this paper are those of the authors and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services.

: The datasets analysed during the current study are not publicly available due to the informed consent obtained not granting permission for deposition in an open-access repository of research data. Qualified investigators may request access to the data as part of a collaboration, in accordance with the project’s institutional review board approval and the participants’ signed informed consent. Requests can be directed to the Principal Investigator of the AADM study, Dr Charles Rotimi (rotimic@mail.nih.gov) and/or the Principal Investigator of the RODAM study, Professor Charles Agyemang (c.o.agyemang@amsterdamumc.nl).

: The analysis code is available at .

: This research was supported in part by the Intramural Research Program of the NIH through the Center for Research on Genomics and Global Health (CRGGH). The CRGGH is also supported by the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of the Director at the NIH (Z01HG200362). KACM is additionally supported by the NIH Pathway to Independence Award (K99/R00) DK131018. Support for participant recruitment and initial genetic studies of the AADM study was provided by NIH grant no. 3T37TW00041-03S2 from the Office of Research on Minority Health. The RODAM study was funded by the European Commission under the Seventh Framework Programme (grant no. 278901).

: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

: APD, AAA and CNR contributed to the conception, design and/or data acquisition of the AADM study. KACM, ELL, PH, EO-D and CA contributed to the conception, design and/or data acquisition of the RODAM study. KACM, AAA and CNR designed the analyses presented in this manuscript. KACM and ELL performed the data analysis. KACM drafted the manuscript with input from all authors. All authors contributed to the interpretation of the data, critically revised the manuscript for important intellectual content and approved the final version for publication. KACM and CNR are responsible for the integrity of the work as a whole.