P-389: Profiles of islet autoantibodies in children with newly diagnosed type 1 diabetes in Vietnam
N T Hang, C T B Ngoc, N T Ha, L T H Hai, B P Thao, N N Khanh, D N Lan, D T K Giang, D T T Huyen, B T Huong, D T Hoa, V C DungAbstract
Introduction
Islet autoantibodies constitute pivotal immunological biomarkers for the diagnosis, subclassification, and stratification of type 1 diabetes (T1D). The number and combination of autoantibodies reflect disease heterogeneity and may be associated with progression risk and beta-cell destruction.
Objectives
To identify the prevalence and characterize the combination profiles of islet autoantibodies among autoantibody-positive children with newly diagnosed T1D.
Methods
This cross-sectional study was conducted at the Center for Endocrinology, Metabolism, Genetics, and Molecular Therapy at the Vietnam National Children’s Hospital from January 2024 to September 2025. A total of 93 children with newly diagnosed T1D and at least one positive islet autoantibody were enrolled. Participants were assessed for five autoantibodies: GADA, IA2-A, ICA, ZnT8A, and IAA. The prevalence of each autoantibody and patterns of single- and multiple-autoantibody positivity were analyzed.
Results
GAD was the most prevalent autoantibody (72.0%), followed by IA2 (61.3%), ICA (60.2%), and ZnT8 (54.8%), while IAA was less frequently detected (19.4%).
Most patients had multiple autoantibodies: 33.3% had two, 25.8% had three, and 20.4% had four; single or all five autoantibodies were less common (15.1% and 5.4%).
Among patients with a single autoantibody, ZnT8 was most common (64.3%). In the two-autoantibody group, ICA+GAD (22.6%) and IA2+GAD (19.4%) were the most frequent combinations. IA2+ICA+GAD was the predominant pattern among patients with three autoantibodies (41.7%), while IA2+ICA+ZnT8+GAD was the most common combination in those with four autoantibodies (63.2%). Notably, GAD was present in most combination patterns.
Conclusions
Multiple autoantibody positivity is common among children with newly diagnosed T1D. GAD appears to play a central role across combinations. Predominant patterns, particularly IA2+ICA+GAD and IA2+ICA+ZnT8+GAD, may reflect a more advanced autoimmune process and indicate a higher-risk immunological profile.