title: Bone Accrual in Males with Autism Spectrum Disorder.
abstract: To test the hypothesis that bone accrual over a 4-year period is reduced in boys with autism spectrum disorder (ASD) compared with typically developing controls.
  
  
  
  Twenty-five boys with ASD and 24 controls were assessed for bone outcomes. Fourteen boys with ASD and 11 controls were assessed both at baseline and after 4 years. The mean subject age was 11.0 ± 1.6 years at study initiation and 14.9 ± 1.6 years at follow-up. Bone mineral density (BMD) was measured at the spine, hip, and whole body using dual-energy X-ray absorptiometry and normalized for age, race, and sex (BMD z-scores). Height adjustments were performed as well. We assessed medical history, physical activity using questionnaires, vitamin D and calcium intake using food records, and serum calcium, phosphorus, 25(OH)-vitamin D, and pubertal hormone levels.
  
  
  
  Boys with ASD had lower spine, hip, and whole body BMD z-scores compared with controls. In those subjects assessed both at baseline and after 4 years, bone accrual rates did not differ between the 2 groups; however, spine and hip BMD z-scores remained lower in the boys with ASD than in controls at follow-up. Notably, the ASD group was less physically active at both time points.
  
  
  
  Although pubertal bone accrual was similar to that in controls, BMD in children with ASD remained low over a 4-year follow-up period, suggesting that low BMD is a consequence of prepubertal factors, such as low physical activity. Studies are needed to investigate the causes and consequences of decreased BMD, to assess BMD in females and adults with ASD, and to evaluate therapeutic interventions.
authors.affiliation: Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA; Harvard Medical School, Boston, MA. Electronic address: aneumeyer@mgh.harvard.edu.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Neumeyer
authors.affiliation: Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Cano Sokoloff
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Boston, MA.
authors.forename: Erin
authors.initials: E
authors.lastname: McDonnell
authors.affiliation: Harvard Medical School, Boston, MA; Biostatistics Center, Massachusetts General Hospital, Boston, MA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Macklin
authors.affiliation: Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA; Harvard Medical School, Boston, MA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDougle
authors.affiliation: Harvard Medical School, Boston, MA; Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital, Boston, MA.
authors.forename: Madhusmita
authors.initials: M
authors.lastname: Misra
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000150:complications*; D015519:Bone Density; D001842:Bone and Bones / Q000503:physiopathology*; D002648:Child; D015444:Exercise; D006801:Humans; D008297:Male
keywords: autism spectrum disorder; bone mineral density