Summary: Up to 1 in 44 children are diagnosed with autism, and those with ASD are at higher risk for obesity. Obesity has been associated with an increased risk of diabetes and other cardiometabolic diseases, including dyslipidemia. The researchers say doctors should monitor children with ASD for signs of cardiometabolic disorders.
Source: Texas technology
A study conducted by the Centers for Disease Control and Prevention (CDC) from 2009 to 2017 determined that approximately 1 in 44 children between the ages of 3 and 17 are diagnosed with some form of autism spectrum disorder (ASD).
Research has also established that children with ASD have an increased risk of obesity, and obesity has been associated with increased risks of cardiometabolic disorders such as diabetes and dyslipidemia (high cholesterol or fat in the body). blood).
However, the question of whether or not there is an association between autism, cardiometabolic disorders and obesity remains largely unanswered.
To help provide insight into the possible link between ASD and cardiometabolic disease, Chanaka N. Kahathuduwa, MD, Ph.D., and a collaborative team from Texas Tech University Health Sciences Center (TTUHSC) and Texas Tech University ( TTU) conducted a systematic review and meta-analysis using PubMed, Scopus, Web of Science, ProQuest, Embase and Ovid databases.
Their study, “Association Between Autism Spectrum Disorders and Cardiometabolic Diseases: A Systematic Review and Meta-analysis,” was published in January by JAMA Pediatricsa journal of the American Medical Association.
Members of the collaborative team included Kahathuduwa, Chathurika S. Dhanasekara, MD, Ph.D., Dominic Ancona, M-PAS, Leticia Cortes, M-PAS, Amy Hu, M-PAS, and Christina Robohm-Leavitt, M- PAS, DMSc, from the TTUHSC School of Health Professions; Afrina H. Rimu, MD, MS, Drew Payne, DO, and Sarah M. Wakefield, MD, of TTUHSC School of Medicine; and Ann M. Mastergeorge, Ph.D., of the TTU College of Human Sciences.
For Kahathuduwa, the seeds of study were planted shortly after earning his doctorate. in Nutritional Sciences with a focus on the neurosciences of obesity. Working as a research assistant professor under Mastergeorge, a nationally recognized ASD expert, he was invited by Naima Moustaid-Moussa, Ph.D., Director of the Obesity Research Cluster at TTU (now the Research Institute on Obesity), to present a seminar on the neurosciences of obesity and autism.
“When I searched the literature to prepare for my presentation, I realized that the evidence for the association between obesity and autism was quite ambiguous,” Kahathuduwa recalls.
“A robust meta-analysis was needed to fill this gap.”
This initial meta-analysis led Kahathuduwa to further research. He explored how neuroimaging can provide insight into the relationships between ASDs and obesity, the association between ASDs and underweight patients, and the just-published study on autism and cardiometabolic risks. Studies accelerated after Dhanasekara, who focused on obesity and metabolic health to earn her doctorate. in Nutritional Sciences, joined the collaboration.
In their latest meta-analysis, Kahathuduwa, Dhanasekara and colleagues assessed 34 studies that included 276,173 participants diagnosed with ASD and 7,733,306 who were not. The results indicated that ASDs were associated with higher risks of developing diabetes overall, including type 1 and type 2 diabetes.
The meta-analysis also determined that autism is associated with increased risks of dyslipidemia and heart disease, although there was no significant increased risk of hypertension and associated stroke. to autism. However, meta-regression analyzes revealed that children with autism had a higher associated risk of developing diabetes and hypertension compared to adults.
Kahathuduwa said the overall results demonstrate the associated increased risk of cardiometabolic disease in patients with ASD, which should prompt clinicians to monitor these patients more closely for potential contributors, including signs of cardiometabolic disease and its complications.
“We established the associations between autism and obesity, as well as autism and cardiometabolic diseases, including diabetes and dyslipidemia,” Kahathuduwa said.
“We don’t have data to support a conclusion that autism causes these metabolic disorders, but since we know that an autistic child is more likely to develop these metabolic complications and disorders later, I thinks doctors should assess autistic children more vigilantly and perhaps start screening them earlier than usual.
Kahathuduwa also thinks the study shows that doctors should think twice before prescribing drugs such as olanzapine, which are well known to have adverse metabolic effects on children with autism.
“Our findings should also open the eyes of autistic patients and parents of autistic children to simply be aware of the higher risk of developing obesity and metabolic complications,” Kahathuduwa added. “Then they can talk with their doctor about obesity and metabolic disease prevention strategies.”
Kahathuduwa said the logical next step for the collaborative team would be to generate evidence that either supports or rejects causation with respect to observed associations.
“We have been working with the ABIDE (Autism Brain Imaging Data Exchange) dataset on how neuroimaging shows the correlation between autism and obesity, but there is still work to be done,” said Kahathuduwa.
“None of these studies would have been possible without the help of the wonderful mentors, collaborators and students at TTUHSC and TTU who have contributed in many ways and who will continue their important efforts to move these studies forward.”
About this autism research news
Author: Suzanna Cisneros
Source: Texas technology
Contact: Suzanna Cisneros – Texas Tech
Picture: Image is in public domain
Original research: Access closed.
“Association between Autism Spectrum Disorders and Cardiometabolic Disease: A Systematic Review and Meta-Analysis” by Chanaka N. Kahathuduwa et al. JAMA Pediatrics
Abstract
Association between autism spectrum disorders and cardiometabolic diseases: a systematic review and meta-analysis
Importance
Although the increased risk of obesity in people with autism has been well established, evidence for the association between autism, cardiometabolic disorders and obesity remains inconclusive.
See also
Objective
To examine the association between autism spectrum disorders and cardiometabolic disease in a systematic review and meta-analysis.
Data sources
The PubMed, Scopus, Web of Science, ProQuest, Embase and Ovid databases were searched from inception through July 31, 2022, with no publication date or language restrictions.
Selection of studies
Observational or baseline data from interventional studies reporting the prevalence of cardiometabolic risk factors (i.e. diabetes, hypertension, dyslipidemia, atherosclerotic macrovascular disease) in children and/or adults autistic and matched with non-autistic participants were included.
Data extraction and synthesis
Screening, data extraction, and quality assessment were performed independently by at least 2 researchers. DerSimonian-Laird random-effects meta-analyses were performed using the meta-package of R.
Main results and measures
The relative risks (RR) of diabetes, hypertension, dyslipidemia, and atherosclerotic macrovascular disease in people with autism were the primary outcomes. Secondary outcomes included RR of type 1 and type 2 diabetes, heart disease, stroke, and peripheral vascular disease.
Results
A total of 34 studies were assessed and included 276,173 participants with autism and 7,733,306 participants without autism (mean age (range), 31.2 (3.8-72.8) years; pooled proportion (range) of women, 47% (0-66%)). Autism was associated with higher risks of developing overall diabetes (RR, 1.57; 95% CI, 1.23-2.01; 20 studies), type 1 diabetes (RR, 1.64 95% CI, 1.06-2.54; 6 studies) and type 2 diabetes (RR, 2.47; 95% CI, 1.30-4.70; 3 studies). Autism was also associated with increased risks of dyslipidemia (RR, 1.69; 95% CI, 1.20-2.40; 7 studies) and heart disease (RR, 1.46; 95% CI , 1.42-1.50; 3 studies). Yet, there was no significantly increased risk of hypertension and stroke associated with autism (RR, 1.22; 95% CI, 0.98-1.52; 12 studies and RR, 1.19; 95% CI, 0.63-2.24; 4 studies, respectively). Meta-regression analyzes revealed that children with autism had a higher associated risk of developing diabetes and hypertension compared to adults. High heterogeneity between studies was a concern for several meta-analyses.
Conclusions and relevance
The results suggest that the associated increased risk of cardiometabolic disease should prompt clinicians to vigilantly monitor people with autism for potential contributors, signs of cardiometabolic disease and its complications.