O'Flaherty Martin, Gomersall Sjaan, Hill Jessica, Fortnum Kathryn, Bourke Matthew, Cairney John, Munns Craig, Simm Peter, Erlandson Marta
School of Human Movement and Nutrition Sciences and Health and Wellbeing Centre for Research Innovation, The University of Queensland, Brisbane, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
J Autism Dev Disord. 2025 Sep 20. doi: 10.1007/s10803-025-07051-z.
Autistic children have been shown to have poorer bone health than their non-autistic peers, but previous evidence on this topic has been based on small clinical samples and is limited by how bone health has been measured. The association between autism and bone health may also reflect confounding by correlated genetic or environmental factors, but prior studies have not addressed this issue.
We address these issues using data from a population-representative cohort of Australian children with bone health measured by peripheral quantitative computed tomography (pQCT) for both children and parents. Data for 1,274 children (66 autistic, 1,208 non-autistic) aged 11-12 years (50% male) were drawn from the Child Health CheckPoint within the Longitudinal Study of Australian Children. pQCT measures at the tibial diaphysis (ankle) and metaphysis (shin) were recorded using an identical protocol for children and one attending parent. Child autism was parent reported. Regression analyses were used to compare differences between autistic and non-autistic children, and between parents of autistic children and parents of non-autistic children.
Our findings indicate poorer bone health as assessed by tibial pQCT among autistic children compared to non-autistic children at both the metaphysis and diaphysis. No differences in pQCT measures were found between parents of autistic and non-autistic children, suggesting no evidence of confounding by shared genetic or environmental factors.
These findings reinforce the need to support improved bone development among autistic children and suggest that differences in bone health are likely driven by behavioural factors that are potentially amenable to intervention.
已有研究表明，自闭症儿童的骨骼健康状况比非自闭症同龄人差，但此前关于这一主题的证据是基于小型临床样本，且受骨骼健康测量方法的限制。自闭症与骨骼健康之间的关联也可能反映了相关遗传或环境因素的混杂影响，但此前的研究尚未解决这一问题。
我们利用来自澳大利亚儿童的具有人群代表性队列的数据来解决这些问题，该队列中的儿童及其父母均通过外周定量计算机断层扫描（pQCT）测量骨骼健康。11至12岁（50%为男性）的1274名儿童（66名自闭症儿童，1208名非自闭症儿童）的数据取自澳大利亚儿童纵向研究中的儿童健康检查点。使用相同的方案记录儿童及其一名陪同家长在胫骨骨干（脚踝）和干骺端（小腿）的pQCT测量值。儿童自闭症情况由家长报告。采用回归分析比较自闭症儿童与非自闭症儿童之间以及自闭症儿童家长与非自闭症儿童家长之间的差异。
我们的研究结果表明，通过胫骨pQCT评估，自闭症儿童在干骺端和骨干的骨骼健康状况均比非自闭症儿童差。自闭症儿童家长与非自闭症儿童家长的pQCT测量值没有差异，这表明没有证据表明存在共同遗传或环境因素的混杂影响。
这些研究结果强化了支持改善自闭症儿童骨骼发育的必要性，并表明骨骼健康差异可能是由行为因素驱动的，而这些行为因素可能适合进行干预。
