Metabolic syndrome in adults with autistic traits: associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative

E B Warreman; L A Nooteboom; P J M Leenen; H M Geurts; M B Terry; J H J Bos; E Hak; H W Hoek; E F C van Rossum; R R J M Vermeiren; W A Ester

doi:10.3389/fpsyt.2023.1303840

Metabolic syndrome in adults with autistic traits: associated psychological, behavioral, and biological factors in females and males - a PharmLines initiative

Front Psychiatry. 2023 Dec 18:14:1303840. doi: 10.3389/fpsyt.2023.1303840. eCollection 2023.

Authors

E B Warreman¹, L A Nooteboom¹, P J M Leenen², H M Geurts^{3

4}, M B Terry⁵, J H J Bos⁶, E Hak⁶, H W Hoek^{5

7

8}, E F C van Rossum^{9

10}, R R J M Vermeiren^{1

8}, W A Ester^{1

8

11}

Affiliations

¹ Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Center, Oegstgeest, Netherlands.
² Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
³ Dutch Autism and ADHD Research Center, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands.
⁴ Dr. Leo Kannerhuis, Youz, Parnassia Group, Amsterdam, Netherlands.
⁵ Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
⁶ Groningen Research Institute of Pharmacy, PharmacoTherapy, Epidemiology and Economics, University of Groningen, Groningen, Netherlands.
⁷ Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands.
⁸ Parnassia Group, Youz, The Hague, Netherlands.
⁹ Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
¹⁰ Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
¹¹ Sarr Autism Rotterdam, Youz, Parnassia Group, Rotterdam, Netherlands.

Abstract

Background: While cardiovascular diseases is highly prevalent and an important cause of mortality in autistic adults, knowledge on their increased cardiovascular risk is limited. Hence, this study aimed to investigate psychological, behavioral, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits.

Methods: In total, 17,705 adults from the Lifelines Cohort were included and categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n = 2,635; males: n = 1803) and lowest levels of autistic traits (LQ-traits-group, n = idem) were analyzed. Using multivariable logistic regression, the associations between MetS and (self-reported and interviewed) psychological, behavioral, and physically measured factors in these stratified groups were investigated.

Results: Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p < 0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p = 0.52). In both the female and male HQ-traits-group, the presence of MetS was associated with poorer self-reported health, less daily physical activity, and altered leukocyte counts.

Conclusion: These findings underline the relevance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the relationship between cardiovascular risk and autistic traits in females, and into tailored cardiovascular prevention.

Keywords: adults; autism; autistic traits; cardiovascular risk; metabolic syndrome.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. “This work, the Lifelines initiative, was supported by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Centre Groningen and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen)” (19). Our study was supported by a grant from the Netherlands Organisation for Health Research and Development (NWO-ZonMw) (grant number 639003101). “The IADB.nl and the PharmLines Initiative are funded by the University of Groningen, Groningen Research Institute of Pharmacy” (20).