A study conducted by the Centers for Disease Control and Prevention (CDC) from 2009 to 2017 found that nearly 1 in 44 children ages 3 to 17 are diagnosed with some form of autism spectrum disorder (ASD). Research has also demonstrated that children with autism spectrum disorder are at increased risk of obesity, and obesity has been linked to an increased risk of cardiovascular disorders such as diabetes and dyslipidemia (a high level of cholesterol or fats in the blood). However, the question of whether or not there is an association between autism, cardiovascular disorders, and obesity remains largely unanswered.
To help provide insight into the potential link to ASD cardiovascular disease, Chanaka N. conducted the review and meta-analysis using PubMed, Scopus, Web of Science, ProQuest, Embase, and Ovid databases. Their study, The Association between Autism Spectrum Disorders and Cardiovascular Disease: A Systematic Review and Meta-Analysis, was published in January by JAMA Pediatricswhich is the Journal of the American Medical Association.
Members of the collaborative team included Kahuduwa, Chaturika S. Danasekara, MD, PhD, Dominic Ancona, M-PAS, Leticia Curtis, M-PAS, Amy Ho, M-PAS and Christina Robum-Levitt, M-PAS, DMSc, from TTUHSC College of Careers health; Afrina H. Rimu, MD, MS, Drew Payne, DO, and Sarah M. Wakefield, MD, of TTUHSC School of Medicine; and Ann M. Mastergeorge, Ph.D. from the TTU Faculty of Humanities.
For Kahathuduwa, the seeds of study were sown shortly after he received his Ph.D. in nutritional sciences with an emphasis on the neuroscience of obesity. Serving as a Research Assistant Professor under the direction of Mastergeorge, a nationally recognized expert in ASD, he was invited by Naima Mosaed Musa, Ph.D., Director of the Obesity Research Group at TTU (now Obesity Research Institute), to present a seminar discussing the neurosciences of obesity and autism.
As I looked through the literature to prepare my presentation, I realized that the evidence for the relationship between obesity and autism was quite ambiguous. A robust meta-analysis was needed to address this gap.”
Chanaka N. Kahathuduwa, MD, Ph.D.
This initial meta-analysis led Kahoduwa to investigate further. Explore how neuroimaging can provide insight into the relationships between ASD and obesity, the relationship between ASD and underweight patients and the just published study on autism and cardiometabolic risk. Studies accelerated after Dhanasekara, who focused on obesity and metabolic health for her Ph.D. In nutritional sciences, join the collaboration.
In a recent meta-analysis, Kahuduwa, Dhanasekara, and collaborators evaluated 34 studies that included 276,173 participants diagnosed with autism and 7,733,306 who were not. The results indicated that ASD was associated with a higher risk of developing diabetes in general, including type 1 and type 2 diabetes.
The meta-analysis also determined that autism is associated with an increased risk of dyslipidemia and heart disease, although there was no significant increase in the risk of hypertension and stroke associated with autism. However, meta-regression analyzes revealed that children with autism were more likely to have diabetes and high blood pressure when compared to adults.
The overall findings show an increased risk associated with cardiovascular disease in patients with ASD, Kahudwa said, which should prompt clinicians to monitor these patients more closely for potential contributors, including signs of cardiovascular disease and complications.
“We established the links between autism and obesity, as well as autism and heart disease, including diabetes and dyslipidemia,” Kahuduwa said. “We don’t have data to support the conclusion that autism causes these metabolic disorders, but since we know that a child with autism is more likely to develop these complications and metabolic disorders down the road, I think clinicians should evaluate children with autism more vigilantly and perhaps start screening them sooner. earlier than usual.”
Kahuduwa also believes the study shows that clinicians should think twice before prescribing medications such as olanzapine, which is well known for its metabolic adverse effects on children with autism.
“Our findings should be an eye-opener for patients with autism and parents of children with autism, just to be aware of the higher risk of obesity and metabolic complications,” added Kahuduwa. Then they can talk to their doctors about strategies for preventing obesity and metabolic diseases.
Kahuduwa said the collaborative team’s next logical step would be to find evidence to support or reject causation regarding the observed correlations.
“We have done some work with the ABIDE (Autism Brain Imaging Data Exchange) data set regarding how neuroimaging shows the relationship between autism and obesity, but there is more work to be done,” said Kahuduwa. “None of these studies would have been possible without the help of the wonderful mentors, collaborators, and students at both TTUHSC and TTU who have contributed in so many ways, and who will continue their important efforts to advance these studies.”
Dhanasekara, C.S., et al. (2023) Associations between autism spectrum disorders and cardiovascular disease: a systematic review and meta-analysis. JAMA Pediatrics. doi.org/10.1001/jamapediatrics.2022.5629.