AAAP Today

CHOLESTEROL, TRIGLYCERIDES AND AUTISM

What’s the relationship? What’s the effect on autism traits?

By Lirio S. Covey, Ph.D.

Recent studies have shown an association between dyslipidemia (abnormally high levels of lipids such as cholesterol and triglycerides in the blood) and autism. Dyslipidemia can be determined by blood tests; it is medically treatable.

1. In a study conducted at Boston’s Children’s Hospital in Massachusetts ( 2.75 million people, 25,514 of whom were children with autism), blood lipid profiles, such as triglyceride levels, were higher in children with autism, regardless (controlled for) of age, medication, sex, or metabolic conditions such as obesity or diabetes.

2. In health care claims of 34 million people across the United States, 6.6 percent of 80,714 autistic persons had dyslipidemia.

3. In the general population, the estimated proportion of children with autism is 1-2%. In a study of parents with a history of dyslipidemia, 16% of them had a greater risk of having autistic children.

What questions concerning autism do these findings raise?

1. Are high lipid levels (cholesterol or triglycerides) risk factors for autism? If so, this association would mark the presence of a potential biological indicator of autism risk.

2. Thus far, there has been no specific biological autism risk factor (with the exception of genes whose relation to autism risk has been widely observed but knowledge of which specific genes or combination of genes are involved remains to be determined). High lipid levels would constitute an additional diagnostic marker of the presence of autism, beyond the established clinically observable signs.

3. Because only a subgroup of persons with autism will demonstrate high lipid levels, would elevated lipid levels identify a particular subtype of autism? This could lead to specific and possibly more targeted, personalized, and efficacious intervention approaches.

4. What neuronal mechanisms related to autism are affected by high lipid levels?

5. Will normalizing elevated lipid levels be therapeutic towards improving behavioral autism traits that impair the day-to-day functioning of autistic individuals?

6. Will normalizing elevated lipid levels reduce premature mortality in persons with autism?

7. Will administering lipid-lowering medications, such as statins, reduce premature mortality in persons with autism?

Reference: Ekaterina Pesheva. Autism-Cholesterol Link. New research reveals a subtype of autism associated with lipid abnormalities. August 17, 2020. Research.

Self-injurious behavior in autism

Self-injurious behaviors (SIB), such as skin picking, head banging, hair pulling, scratching, are frequently seen among individuals with autism. Up to half of autistic people harm themselves, and SIB can be persistent. In a research study, self-injurious behavior persisted in over 44% of such cases during a 10-year period.

The common predictors of SIB are impulsivity and over-activity. Other predictors are stereotyped behavior, problems in social communication and reduced self-control. SIBs may provide a physical outlet for emotional pain. They are observed more often in women with autism as in men with the condition.

Uncontrolled SIB can lead to adverse consequences on educational, work, health and social outcomes. Caregivers and clinicians should be sensitive and observant to their occurrence. SIBs call for help as early as possible, even during the childhood years once they are detected. Interestingly, SIB can be subject to self-restraint indicating that the underlying difficulty in impulse control can be addressed by behavioral modification approaches.

References:

Laverty C et al, Molecular Autism, 2020 Jan 20: 11:8. Persistence and predictors of self-injurious behavior in autism: a ten-year prospective cohort study.-

Maddox BB et al, Autism, May 21 (4) 412-422. 2017. Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder.

Autism: A Quick Trip To My Home Planet, by Monique Botha, TEDxSurrey University.
An outstanding talk by a young woman describing her experiences as an autism, in the process addressing and correcting many myths about autism.

https://youtu.be/NCAErePScO0