1301-P: Frequency of Single Autoantibody Positivity (SAB+) Varies by Race/Ethnicity and Area Deprivation Index in Individuals at Risk for Type 1 Diabetes (T1D)

Introduction & Objective: The diversity of individuals living with T1D has increased, driven by Hispanic (H) and non-Hispanic Black (NHB) populations. Yet, whether H and NHB populations have different rates of SAB+ than other groups, which can impact clinical care and research opportunities, has not been well characterized. Area deprivation and race/ethnicity are strongly associated with each other and have compounding and adverse effects on diabetes-related health outcomes. We examined TrialNet data from relatives of persons with T1D screened for pancreatic autoantibodies and evaluated the frequency of SAB+ by race/ethnicity and area deprivation.

Methods: Persons (n=28330) screened between 4/9/19-12/31/22 were included. Race/ethnicity was categorized as non-Hispanic white (NHW), H, NHB, and non-Hispanic other (NHO). Home address zip codes were used to assign an Area Deprivation Index, a Health and Human Services Administration index incorporating neighborhood income, education, employment, and housing that ranges from 1 (least deprived) to 100 (most deprived). Deprivation was analyzed in quintiles.

Results: A majority (80.7%) self-identified as NHW; fewer as H (9.8%), NHB (2.5%), and NHO (7.0%). Deprivation differed by race/ethnicity (NHW 46±23, H: 45±24, NHB: 53±23, and NHO: 39±25, p<0.001). SAB+ was more common in NHB and H than NHO and NHW individuals (Overall: 3.0%, NHB: 4.7%, H: 3.8%, NHO: 3.1%, NWH: 3.0%; χ² p=0.02). Logistic regression identified a linear relationship between SAB+ and deprivation (Deprivation quintiles 1 to 5: 2.9%, 2.7%, 3.1%, 3.1%, 3.5%; p=0.04).

Conclusion: These data suggest SAB+ status varies by both race/ethnicity and deprivation which warrants further investigation. Understanding patterns of autoantibody positivity that occur in diverse populations at risk for T1D is foundational to identifying persons who are SAB+ or in early stages of T1D who may now be eligible for preventive therapies.