(Sept. 17, 2014) Individuals with autism have higher than typical rates of bone fracture beginning in childhood and extending up to at least age 50, according to a large study by physician-researchers in the Autism Speaks Autism Treatment Network (ATN).
The increased risk was greatest among girls and women affected by autism spectrum disorder:
* Girls with autism had eight times the hip-fracture rate of other girls.
* Women with the disorder had ten times the rate of spinal fracture of other women.
* Boys with autism had double the hip-fracture rate of other boys.
* Men and women with autism (ages 23 to 50) had nearly 12 times the hip fracture rate of other adults.
* Women with autism also had double the rate of arm, wrist and hand fractures.
Harvard neurologist Ann Neumeyer and endocrinologist Madhusmita Misra presented their team’s findings at the 2014 meeting of the American Society for Bone and Mineral Research, in Houston. Dr. Misra practices in Boston’s MassGeneral Children Hospital, Dr. Neumeyer in the hospital’s Lurie Center for Autism – both of which are part of the Autism Speaks ATN.
“Their findings extend what we’ve long known about autism affecting organ systems beyond the brain,” comments Paul Wang, Autism Speaks senior vice president and head of medical research. “It also illustrates that these health issues are lifelong.” (Dr. Wang was not directly involved in the study.)
From pilot study to review of national records
The worrisome findings come out of the researchers’ review of 2010 emergency-room records from across the United States. This included 18,322 children and 4,215 nonelderly adults (up to age 50) affected by autism. It compared their fracture rates to those of 6.3 million children and 11.5 million adults unaffected by the disorder.
The nation-wide investigation followed up on concerns raised by an earlier pilot study made possible through funding provided to the Autism Speaks ATN in its role as the federally funded Autism Intervention Research Network on Physical Health (AIR-P). That study, also led by Drs. Misra and Neumeyer, found decreased bone density among 18 adolescent boys affected by autism, compared to 19 adolescent boys without the disorder. This raised the question of whether the decreased bone density resulted in more fractures.
The marked increase in fractures uncovered by the new study may stem – at least in part – from autism-related differences in nutrition and exercise, the authors conclude.
“We need to learn more about bone development in autism and how to optimize bone development in children with autism,” Dr. Neumeyer says.
“Our collaboration and findings are an example of the importance of the work funded by the Autism Speaks ATN/AIR-P,” she adds. “This illustrates how the pilot studies funded by the network can lead to further investigations with significant consequences.”