Children, adults with autism spectrum disorder at increased risk for hip fracture

Adults and children with autism spectrum disorder have lower bone mineral density, putting them at higher risk for fractures, particularly of the hip, according to research presented at the American Society for Bone and Mineral Research 2014 Annual Meeting.

“We have previously reported lower bone mineral density (BMD) in peripubertal boys with autism spectrum disorder (ASD) than in typically developing controls,” the researchers wrote in the abstract. “However, it is not clear whether low BMD in ASD results in an increased risk for fracture.”

Madhusmita Misra, MD, Ann Neumeyer, MD, and colleagues evaluated 18,322 children aged 3 to 22 years and 4,215 adults aged 23 to 50 years with ASD, as well as 6,311,505 children and 11,438,194 adults without ASD, to determine rates and type of fractures among them.

Madhusmita Misra

In the child participant group, there was a higher risk for hip fracture among those with ASD compared with those without (P<.0001); the difference was more pronounce in girls (P=.0005) vs. boys (P=.06). However, among child participants with ASD, upper extremity fractures were less common among boys (P<.0001).

Ann Neumeyer

Similarly, adults with ASD had a higher risk for hip fracture compared with adults without ASD (P<.0001); the risk was similar for both men and women (both P<.0001).

Risk for upper extremity fractures was greater among men without ASD compared with men with ASD. No increased risk was found for spine fractures.

Compared with women without ASD, women with ASD had a higher risk for upper extremity fractures (P=.0038) and spine fractures (P=.0034).

According to the researchers, further study is needed to understand the implication of decreased bone density in autism for fracture development.

“Both children and adults with ASD are at increased risk for hip fracture, and women with ASD are also at risk for fractures of the upper extremity and spine,” Misra told Endocrine Today. “We are still in the process of determining the factors that contribute to this increase in fracture risk. However, until these determinants are known, it is important to optimize weight-bearing activities, as well as calcium and vitamin D intake in this population.” — by Amber Cox

For more information:

Misra M. Abstract 1098. Presented at: American Society for Bone and Mineral Research 2014 Annual Meeting; Sept. 12-15, 2014; Houston.

Disclosure: The researchers report no relevant financial disclosures.