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. 2025 Jul 1;25(1):155.
doi: 10.1186/s12902-025-01969-2.

Clinical and serological characteristics of type 3 APS, isolated T1DM and LADY/LADA

Yawei Qiu  1 , Lin Guo  1 , Hongyan Pan  1 , Huaqiu He  1 , Qiang Li  2
Affiliations

Clinical and serological characteristics of type 3 APS, isolated T1DM and LADY/LADA

Yawei Qiu et al. BMC Endocr Disord. .

Abstract

Background: There are few studies comparing Type 3 autoimmune polyendocrine syndromes (APS) with isolated type 1 diabetes mellitus (T1DM), latent autoimmune diabetes in youth (LADY), and latent autoimmune diabetes in adults (LADA) in the Chinese population. This study aims to report the clinical and serological characteristics of Chinese patients with Type 3 APS, isolated T1DM, LADY and LADA, and to make comparisons.

Methods: This study retrospectively analyzed the clinical and serological characteristics of hospitalized patients with Type 3 APS, T1DM, LADY and LADA who were admitted to our center.

Results: A total of 69 patients were included in this study, comprising 18 with Type 3 APS, 20 with T1DM, and 31 with LADY/LADA. The majority of Type 3 APS patients were female, whereas T1DM and LADY/LADA groups had a higher proportion of males. The median age and onset age of diabetes in the Type 3 APS group were 35.50 (31.00, 52.50) years and 30.50 (26.75, 47.25) years, respectively. Diabetes and autoimmune thyroid disease (AITD) in Type 3 APS patients may occur simultaneously or several years apart. The levels of GADAb and thyroid autoantibodies in Type 3 APS patients were often higher.

Conclusions: Type 3 APS exhibits differences when compared to isolated T1DM and LADY/LADA. For patients with TIDM or LADY/LADA, especially female patients, those over 30 years old or with high-titer GADAb, attention should be paid to screening for APS 3, including the detection of thyroid autoantibodies. Patients suspected or confirmed to have Type 3 APS need long-term follow-up.

Clinical trial number: Not applicable.

Keywords: Isolated type 1 diabetes mellitus; Latent autoimmune diabetes in adults; Latent autoimmune diabetes in youth; Retrospective study; Type 3 autoimmune polyendocrine syndromes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This work has been carried out in accordance with the Declaration of Helsinki (2013) of the World Medical Association. This study was approved by the Ethic Committee of Shenzhen University General Hospital (No. KYLL-20230703 A). This article is a retrospective study. Therefore, the Ethic Committee of Shenzhen University General Hospital waived the requirement to obtain distinct written informed consent from the patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age of Onset of Diabetes and AITD
Fig. 2
Fig. 2
Time Interval between Onset of First (X-axis) and Second Endocrine Component Diseases (Y-axis) in 18 APS 3 Patients. The chart displays medians, first and third quartiles, as well as ranges of time between the onset of the first and second diseases. The subgroup breakdown includes 8 cases of first T1DM occurrence followed by AITD, 4 cases of first AITD occurrence followed by T1DM, and 6 cases with both diseases occurring in the same year
Fig. 3
Fig. 3
GADAb Levels in Three Patient Groups. The statistical analysis revealed a significant difference among the three groups (P = 0.022)
Fig. 4
Fig. 4
Distribution of Thyroid Autoantibodies in Patients from APS 3, T1DM, and LADY/LADA Groups with Different GADAb Titers. (A) Prevalence of TPOAb, TGAb, and TRAb in Patients from All Three Groups with Low GADAb Titers. (B) Prevalence of TPOAb, TGAb, and TRAb in Patients from All Three Groups with High GADAb Titers
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