A study conducted from 2009 to 2017 by the Centers for Disease Control and Prevention (CDC) established that children with autism are at increased risk of obesity, and obesity was associated with an increased risk of cardiometabolic diseases such as diabetes and dyslipidemia (high) has been added. cholesterol or fat levels in the blood). However, the question of whether there is an association between autism, cardiometabolic disorders and obesity remains unanswered.
To help provide insight into the potential link between autism and cardiometabolic diseases, Chanaka N. Kahathuduwa, MD, and a collaborative team from the Texas Tech University Health Science Center (TTUHSC) and Texas Tech University (TTU) conducted a systematic review and meta-analysis. -Analyzed using PubMed, Scopus, Web of Science, ProQuest, Embase, and Ovid databases. Their study, “Association Between Autism Spectrum Disorder and Cardiometabolic Disease: A Systematic Review and Meta-Analysis,” was published in January by JAMA Pediatrics, a journal of the American Medical Association.
For Kahathuduwa, the seeds of study were planted soon after she obtained her PhD in nutritional science with a focus on the neuroscience of obesity. Working as a research assistant professor with nationally renowned autism expert NM Mastergeorge, he was invited by Dr. Naima Mousted-Moussa, Director of the Obesity Research Group at TTU (now the Obesity Research Institute). Obesity and the neuroscience of autism.
“When I researched the literature to prepare my presentation, I realized that the evidence on the association between obesity and autism was quite mixed,” Kathuduva recalled. “A robust meta-analysis was needed to address this gap.”
The initial meta-analysis prompted Kahathuduwa to investigate further. They explored how neuroimaging could provide insight into the relationship between autism and obesity, between patients with autism and those who are underweight.
In their latest meta-analysis, Kahathuduva and colleagues evaluated 34 studies that included 276,173 participants who were diagnosed with autism and 7,733,306 who were not. The results indicated that autism was associated with increased risks of diabetes overall, including type 1 and type 2 diabetes.
The meta-analysis also found that autism is associated with an increased risk of dyslipidemia and cardiovascular disease, although there was no significant increased risk of hypertension and stroke associated with autism. However, meta-regression analysis showed that children with autism had a higher risk of developing diabetes and hypertension than adults.
Kahathuduwa said the overall results demonstrate an increased risk of cardiometabolic disease in patients with autism, prompting physicians to monitor these patients more closely for potential triggers, including signs of cardiometabolic disease and its complications.
“We have established associations between autism and obesity, as well as between autism and cardiometabolic diseases, including diabetes and dyslipidemia,” said Kahathuduwa. “We don’t have data to support the conclusion that autism is causing these metabolic disorders, but because we know that a child with autism is more likely to develop these metabolic complications and disorders in the future, my believe clinicians should evaluate children with autism more closely and perhaps begin evaluating them earlier than usual.”
Kahthuduwa also believes the study suggests doctors should think twice before prescribing drugs like olanzapine, which are known to have adverse metabolic effects, in children with autism.
“Our findings should also be an eye-opener for autism patients and parents of children with autism regarding obesity and the increased risk of developing metabolic complications,” said Kahathuduwa. “They can then talk with their doctors about strategies to prevent obesity and metabolic diseases.”
Kahthuduwa said the next logical step for the collaborative team would be to generate evidence that supports or disproves causality with respect to the observed associations.
“We have done some work with the ABIDE (Autism Brain Imaging Data Exchange) dataset on how neuroimaging characterizes the relationship between autism and obesity, but there is more work to be done,” Kathuduva said. “None of these studies would have been possible without the help of the wonderful advisors, collaborators and students at TTUHSC and TTU who contributed in many ways and who will continue their important efforts to advance these studies.”