Abstract
<jats:p><p dir="ltr">Objective: Islet autoantibody positivity (AB+) has not been evaluated across different race, ethnicity, and categories of socioeconomic deprivation categories in individuals at risk for type 1 diabetes. We examined data from TrialNet of persons screened for ABs and evaluated patterns by race/ethnicity and socioeconomic deprivation.</p><p><br></p><p dir="ltr">Research Design and Methods: This analysis included 139,963 relatives of people with type 1 diabetes screened by TrialNet between 1/9/12-12/31/22. Race/ethnicity was categorized as non-Hispanic white (NHW), Hispanic, non-Hispanic Black (NHB), and non-Hispanic other (NHO). Home addresses were used to assign deprivation, ranging from least (1) to most deprived (100), analyzed in quintiles. Descriptive and multivariate analyses were conducted to assess associations between race/ethnicity, deprivation, and AB+, adjusting for age and protocol period.</p><p><br></p><p dir="ltr">Results: Single (SAB+) and multiple autoantibody positivity (MAB+) varied by age, race/ethnicity, and deprivation. Younger individuals had increased odds of MAB+ and decreased odds of SAB+. NHB participants had significantly higher odds of AB+ (aOR=1.44 [1.29,1.62]), SAB+ (aOR=1.59 [1.38,1.85]), and MAB+ (aOR=1.26 [1.06,1.51]), while Hispanic individuals had higher odds of SAB+ (aOR=1.26 [1.15,1.39]) and lower odds of MAB+ (aOR=0.81 [0.72,0.91]) compared to NHW. Lowest deprivation was associated with higher odds of MAB+ (aOR=1.21 [1.06,1.37]), but not SAB+. </p><p><br></p><p dir="ltr">Conclusion and Relevance: AB+ patterns vary by race, ethnicity, and deprivation. Screening and prevention strategies should be designed to identify individuals at risk based on these factors to enable equitable risk stratification and access to diabetes preventive therapies. </p></jats:p>