Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA.
Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
Sci Rep. 2022 Jun 13;12(1):9737. doi: 10.1038/s41598-022-13365-0.
Adults with autism spectrum disorder (ASD) are at risk for excess bodyweight and hypertension, yet the prevalence of and clinical predictors for these health conditions remain unknown. The objective of this study was to assess the prevalence of overweight, obesity, and hypertension in a large clinical sample of adults with a confirmed diagnosis of ASD and to examine potential clinical predictors. This retrospective chart review study included adult subjects (≥ 20 years) with ASD who had been seen within the past 5 years at a multidisciplinary developmental disorders clinic. Data collected from the electronic health record included age, sex, race and ethnicity, cognitive ability, language ability, body mass index (BMI), hypertension, and use of second generation antipsychotic medications (SGAs). Of 622 adults with a confirmed diagnosis of ASD potentially eligible for the study, 483 (78%) had one or more notes in their records from the past 5 years. Those with recent notes were 23% female, 89% White, and had a mean (SD) age of 28.1 (7.1) years. Overall prevalence estimates for adults represented by this predominantly male, White, and young clinical sample were 28% (95% CI 24%, 32%) for overweight (BMI 25-29.9 kg/m), 35% (95% CI 31%, 40%) for obesity (≥ 30 kg/m), and 11% (95% CI 9%, 15%) for hypertension. Controlling for age and sex, intellectual disability (ID) was significantly associated with BMI (p = 0.003) but not hypertension (p = 0.69); those with moderate or more severe ID had a mean BMI that was 2.26 kg/m (95% CI 0.96, 3.57) lower than those with no ID. Controlling for age and sex, neither language ability, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) subtype of autism, nor past or current use of SGAs were significantly associated with BMI or hypertension. The study identified a high prevalence of overweight and obesity in adults with ASD consistent with the prevalence of these medical comorbidities in the U.S. population.
成人自闭症谱系障碍（ASD）患者存在超重和高血压的风险，但这些健康状况的流行率和临床预测因素仍不清楚。本研究的目的是评估大量经临床确诊的 ASD 成年患者中超重、肥胖和高血压的流行率，并探讨潜在的临床预测因素。这项回顾性图表研究纳入了在过去 5 年内于多学科发育障碍诊所就诊的 ASD 成年患者（≥20 岁）。从电子病历中收集的数据包括年龄、性别、种族和民族、认知能力、语言能力、体重指数（BMI）、高血压和第二代抗精神病药物（SGAs）的使用情况。在 622 名可能符合研究条件的 ASD 成年患者中，有 483 名（78%）在过去 5 年内的病历中有 1 份或多份记录。有近期记录的患者中，23%为女性，89%为白人，平均（SD）年龄为 28.1（7.1）岁。该临床样本主要为男性、白人且年轻，其代表的成年人总体患病率估计值分别为：超重（BMI 25-29.9kg/m）占 28%（95%CI 24%，32%），肥胖（≥30kg/m）占 35%（95%CI 31%，40%），高血压占 11%（95%CI 9%，15%）。在控制年龄和性别后，智力障碍（ID）与 BMI 显著相关（p=0.003），但与高血压无关（p=0.69）；中度或更严重 ID 患者的平均 BMI 比无 ID 患者低 2.26kg/m（95%CI 0.96，3.57）。在控制年龄和性别后，语言能力、《精神障碍诊断与统计手册》第四版（DSM-IV）自闭症亚型以及过去或目前使用 SGAs 均与 BMI 或高血压无显著相关性。该研究发现 ASD 成年患者超重和肥胖的患病率较高，与美国人群中这些合并症的患病率一致。
