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Bone Mass in Boys with Autism Spectrum Disorder

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Abstract

To examine bone mass in children and adolescents with autism spectrum disorders (ASD). Risperidone-treated 5 to 17 year-old males underwent anthropometric and bone measurements, using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Multivariable linear regression analysis models examined whether skeletal outcomes differed among participants with (n = 30) versus without ASD (n = 156). After adjusting for potential covariates, having ASD was associated with significantly lower trabecular bone mineral density and bone strength at the radius, and with marginally lower total body less head bone mineral content (p < 0.09). No differences at the lumbar spine were observed. ASD are associated with lower bone mass. Future studies should investigate interventions to optimize skeletal health in ASD.

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References

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: Research Center for Children, Youth and Families.

    Google Scholar 

  • Aman, M. G., Arnold, L. E., McDougle, C. J., Vitiello, B., Scahill, L., Davies, M., et al. (2005). Acute and long-term safety and tolerability of risperidone in children with autism. Journal of Child and Adolescent Psychopharmacology, 15(6), 869–884. doi:10.1089/cap.2005.15.869.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • Bahr, S. M., Tyler, B. C., Wooldridge, N., Butcher, B. D., Burns, T. L., Teesch, L. M., et al. (2015). Use of the second-generation antipsychotic, risperidone, and secondary weight gain are associated with an altered gut microbiota in children. Translational Psychiatry, 5, e652. doi:10.1038/tp.2015.135.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baim, S., Leonard, M. B., Bianchi, M. L., Hans, D. B., Kalkwarf, H. J., Langman, C. B., et al. (2008). Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Pediatric Position Development Conference. Journal of Clinical Densitometry, 11(1), 6–21.

    Article  PubMed  Google Scholar 

  • Block, G., Murphy, M., Roullet, J. B., Wakimoto, P., Crawford, P. B., & Block, T. (2000, September 17–20). Pilot validation of a FFQ for children 8–10 years (Abstract). Paper presented at the 4th International Conference On Dietary Assessment Methods. Tucson, AZ.

  • Bonnick, S. L., Johnston, C. C. Jr., Kleerekoper, M., Lindsay, R., Miller, P., Sherwood, L., et al. (2001). Importance of precision in bone density measurements. Journal of Clinical Densitometry, 4(2), 105–110.

    Article  PubMed  Google Scholar 

  • Calarge, C. A., Ivins, S. D., Motyl, K. J., Shibli-Rahhal, A. A., Bliziotes, M. M., & Schlechte, J. A. (2013). Possible mechanisms for the skeletal effects of antipsychotics in children and adolescents. Therapeutic Advances in Psychopharmacology, 3(5), 278–293. doi:10.1177/2045125313487548.

    Article  PubMed  PubMed Central  Google Scholar 

  • Calarge, C. A., Nicol, G., Schlechte, J. A., & Burns, T. L. (2014). Cardiometabolic outcomes in children and adolescents following discontinuation of long-term risperidone treatment. Journal of Child and Adolescent Psychopharmacology, 24(3), 120–129. doi:10.1089/cap.2013.0126.

    Article  PubMed  PubMed Central  Google Scholar 

  • Calarge, C. A., Schlechte, J. A., Burns, T. L., & Zemel, B. S. (2015). The effect of psychostimulants on skeletal health in boys co-treated with risperidone. The Journal of Pediatrics, 166(6), 1449–1454 e1441. doi:10.1016/j.jpeds.2015.03.005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Calarge, C. A., Xie, D., Fiedorowicz, J. G., Burns, T. L., & Haynes, W. G. (2012). Rate of weight gain and cardiometabolic abnormalities in children and adolescents. The Journal of Pediatrics, 161(6), 1010–1015. doi:10.1016/j.jpeds.2012.05.051.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cashin, A., Buckley, T., Trollor, J. N., & Lennox, N. (2016). A scoping review of what is known of the physical health of adults with autism spectrum disorder. Journal of Intellectual Disabilities. doi:10.1177/1744629516665242.

    PubMed  Google Scholar 

  • Hategan, A., Bourgeois, J. A., & Goldberg, J. (2016). Aging with autism spectrum disorder: an emerging public health problem. International Psychogeriatrics/IPA. doi:10.1017/S1041610216001599.

    Google Scholar 

  • Hediger, M. L., England, L. J., Molloy, C. A., Yu, K. F., Manning-Courtney, P., & Mills, J. L. (2008). Reduced bone cortical thickness in boys with autism or autism spectrum disorder. Journal of Autism and Developmental Disorders, 38(5), 848–856. doi:10.1007/s10803-007-0453-6.

    Article  PubMed  Google Scholar 

  • Mouridsen, S. E., Rich, B., & Isager, T. (2012). Fractures in individuals with and without a history of infantile autism. A Danish register study based on hospital discharge diagnoses. Journal of Autism and Developmental Disorders, 42(4), 619–624. doi:10.1007/s10803-011-1286-x.

    Article  PubMed  Google Scholar 

  • Neumeyer, A. M., Cano Sokoloff, N., McDonnell, E., Macklin, E. A., McDougle, C. J., & Misra, M. (2017). Bone microarchitecture in adolescent boys with autism spectrum disorder. Bone, 97, 139–146. doi:10.1016/j.bone.2017.01.009.

    Article  PubMed  Google Scholar 

  • Neumeyer, A. M., Gates, A., Ferrone, C., Lee, H., & Misra, M. (2013). Bone density in peripubertal boys with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(7), 1623–1629. doi:10.1007/s10803-012-1709-3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Neumeyer, A. M., O’Rourke, J. A., Massa, A., Lee, H., Lawson, E. A., McDougle, C. J., & Misra, M. (2015). Brief report: Bone fractures in children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(3), 881–887. doi:10.1007/s10803-014-2228-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nilas, L., & Christiansen, C. (1988). Rates of bone loss in normal women: evidence of accelerated trabecular bone loss after the menopause. European Journal of Clinical Investigation, 18(5), 529–534.

    Article  PubMed  Google Scholar 

  • Ogden, C. L., Kuczmarski, R. J., Flegal, K. M., Mei, Z., Guo, S., Wei, R., et al. (2002). Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics, 109(1), 45–60.

    Article  PubMed  Google Scholar 

  • Osteoporosis prevention, diagnosis, and therapy. (2001). Jama, 285(6), 785–795.

    Article  Google Scholar 

  • Pitukcheewanont, P., & Chen, P. (2005). Bone density measurements in children and adolescents. Quantitative computed tomography versus dual-energy X-ray absorptiometry. The Endocrinologist, 15(4), 232–239.

    Article  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39(1), 28–38.

    Article  PubMed  Google Scholar 

  • Slemenda, C. W., Miller, J. Z., Hui, S. L., Reister, T. K., & Johnston, C. C. Jr. (1991). Role of physical activity in the development of skeletal mass in children. Journal of Bone and Mineral Res0earch, 6(11), 1227–1233.

    Article  Google Scholar 

  • Specker, B. L., & Schoenau, E. (2005). Quantitative bone analysis in children: current methods and recommendations. The Journal of pediatrics, 146(6), 726–731. doi:10.1016/j.jpeds.2005.02.002.

    Article  PubMed  Google Scholar 

  • Walter, S. D., Eliasziw, M., & Donner, A. (1998). Sample size and optimal designs for reliability studies. Statistics in Medicine, 17(1), 101–110.

    Article  PubMed  Google Scholar 

  • Zemel, B. S., Kalkwarf, H. J., Gilsanz, V., Lappe, J. M., Oberfield, S., Shepherd, J. A., et al. (2011). Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: results of the bone mineral density in childhood study. The Journal of Clinical Endocrinology and Metabolism, 96(10), 3160–3169. doi:10.1210/jc.2011-1111.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors thank the participants and their families as well as the research team members.

Funding

This study was funded by a 2005 and a 2007 NARSAD Young Investigator Award, a Fraternal Order of Eagle Diabetes Research Center pilot grant, and by the National Institutes of Health (RR024979, R21MH080968, and K23MH085005). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Author Contribution

CAC conceptualized, designed, and conducted the studies, carried out the analyses, and wrote the first draft of the manuscript. JAS contributed to study design and conduct and to reviewing the manuscript.

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Authors and Affiliations

  1. Menninger Department of Psychiatry and Behavioral Science and Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, 1102 Bates Ave, Suite 790, Houston, TX, 77030, USA

    Chadi A. Calarge

  2. Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City, 52242, IA, USA

    Janet A. Schlechte

Authors
  1. Chadi A. Calarge
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  2. Janet A. Schlechte
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Correspondence to Chadi A. Calarge.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Written informed consent was obtained from parents or legal guardians of all individual participants and assent was obtained from the participants.

Additional information

Dr. Calarge was at the University of Iowa when he conducted this study. He is now at Baylor College of Medicine.

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Calarge, C.A., Schlechte, J.A. Bone Mass in Boys with Autism Spectrum Disorder. J Autism Dev Disord 47, 1749–1755 (2017). https://doi.org/10.1007/s10803-017-3097-1

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  • DOI: https://doi.org/10.1007/s10803-017-3097-1

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