title: Autism Spectrum Disorders and Metabolic Complications of Obesity.
abstract: OBJECTIVE
  To assess for an increased risk of obesity, type 2 diabetes mellitus, hypertension, hyperlipidemia, and nonalcoholic fatty liver disease/nonalcoholic steatohepatitis in children with autism spectrum disorders (ASD). Additionally, to determine the rates of prescribed treatment for obesity-related metabolic disorders and to determine whether treatment with psychotropic medications is associated with the development of obesity for children with ASD.
  
  
  METHODS
  A retrospective 1:5 case-control study was performed by use of the Military Health System database from October 2000 to September 2013. For children with ASD and matched controls, International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes for obesity, type 2 diabetes mellitus, hypertension, hyperlipidemia, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, and prescriptions were obtained. Conditional logistic regression determined ORs and 95% CIs.
  
  
  RESULTS
  A total of 48 762 individuals with ASD and 243 810 matched controls were identified. Children with ASD had significantly greater odds of having obesity (OR 1.85; 95% CI 1.78-1.92), having obesity-related disorders, and being prescribed a medication when they had these diseases. In children with ASD, mood stabilizers, antipsychotics, antiepileptic drugs, and selective serotonin reuptake inhibitors were associated with obesity.
  
  
  CONCLUSIONS
  Children with ASD have an increased risk of obesity and obesity-related metabolic disorders. They are more likely to be prescribed medications to treat these complications, suggesting they may have more severe disease. There is a significant association between the use of some psychotropic categories and a diagnosis of obesity, suggesting that obesity in children with ASD may be partially iatrogenic.
authors: Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland. Electronic address: katherine.shedlock.1@us.af.mil.
authors: Katherine
authors: K
authors: Shedlock
authors: Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors: Apryl
authors: A
authors: Susi
authors: Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors: Gregory H
authors: GH
authors: Gorman
authors: Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors: Elizabeth
authors: E
authors: Hisle-Gorman
authors: Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors: Christine R
authors: CR
authors: Erdie-Lalena
authors: Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors: Cade M
authors: CM
authors: Nylund
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D000067877:Autism Spectrum Disorder / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants; D011619:Psychotropic Drugs
keywords: hyperlipidemia; hypertension; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; type 2 diabetes mellitus