Association Between Autism Spectrum Disorders and Cardiometabolic Diseases: A Systematic Review and Meta-analysis.

This large study looked at heart and metabolism health in autistic people compared to non-autistic people. Researchers found that autistic individuals have higher risks of developing diabetes (both type 1 and type 2), high cholesterol, and heart disease. The risks were especially high for autistic children compared to adults. However, there wasn't a clear link with high blood pressure or stroke. This means doctors should regularly check autistic people for these health conditions.

This comprehensive systematic review and meta-analysis examined cardiometabolic health risks in autism spectrum disorders by analyzing 34 studies with over 8 million participants. The research found that autistic individuals face significantly elevated risks for several cardiometabolic conditions, including 57% higher risk for diabetes overall, 64% increased risk for type 1 diabetes, and 147% higher risk for type 2 diabetes. Additionally, autism was associated with 69% greater risk of dyslipidemia and 46% increased risk of heart disease. Notably, children with autism showed greater associated risks for diabetes and hypertension compared to adults.

However, no significant associations were found with hypertension or stroke risk.

Results indicate clinicians should implement routine cardiometabolic screening for autistic individuals, particularly focusing on diabetes, dyslipidemia, and cardiovascular health. Early monitoring and preventive interventions are especially crucial for autistic children. Healthcare providers should develop comprehensive care protocols addressing these elevated health risks.

High between-study heterogeneity was noted across several analyses, which may affect result reliability. The study design prevents establishing causation, only association. Potential confounding factors and varying study methodologies across included research may influence findings.

Although the increased risk of obesity among individuals with autism has been well established, evidence on the association between autism, cardiometabolic disorders, and obesity remains inconclusive. To examine the association between autism spectrum disorders and cardiometabolic diseases in a systematic review and meta-analysis. PubMed, Scopus, Web of Science, ProQuest, Embase, and Ovid databases were searched from inception through July 31, 2022, without restrictions on date of publication or language. Observational or baseline data of interventional studies reporting the prevalence of cardiometabolic risk factors (ie, diabetes, hypertension, dyslipidemia, atherosclerotic macrovascular disease) among children and/or adults with autism and matched with participants without autism were included.

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 in R. Relative risks (RRs) of diabetes, hypertension, dyslipidemia, and atherosclerotic macrovascular disease among individuals with autism were the primary outcomes. Secondary outcomes included the RR of type 1 and type 2 diabetes, heart disease, stroke, and peripheral vascular disease.

A total of 34 studies were evaluated and included 276 173 participants with autism and 7 733 306 participants without autism (mean [range] age, 31.2 [3.8-72.8] years; pooled proportion [range] of female individuals, 47% [0-66%]). Autism was associated with greater risks of developing diabetes overall (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 associated increased risk of hypertension and stroke 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 analyses revealed that children with autism were at a greater associated risk of developing diabetes and hypertension compared with adults. High between-study heterogeneity was a concern for several meta-analyses. Results suggest that the associated increased risk of cardiometabolic diseases should prompt clinicians to vigilantly monitor individuals with autism for potential contributors, signs of cardiometabolic disease, and their complications.