Skip to main content
SpringerLink
Log in

Bone Density in Peripubertal Boys with Autism Spectrum Disorders

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

We determined whether bone mineral density (BMD) is lower in boys with autism spectrum disorders (ASD) than controls, and also assessed variables that may affect BMD in ASD. BMD was measured using dual energy X-ray absorptiometry (DXA) in 18 boys with ASD and 19 controls 8–14 years old. Boys with ASD had lower BMD Z-scores at the spine, hip and femoral neck, and differences at the hip and femoral neck persisted after controlling for maturity and BMI. Vitamin D intake from food and in serum were lower in ASD subjects, as was exercise activity. We conclude that BMD is lower in peripubertal boys with ASD and may be associated with impaired vitamin D status and lower exercise activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

BMD:

Bone mineral density

BMAD:

Bone mineral apparent density

DXA:

Dual energy X-ray absorptiometry

ASD:

Autism spectrum disorder

IGF-1:

Insulin-like growth factor-1

TSH:

Thyroid stimulating hormone

T4:

Thyroxine

P1NP:

N-terminal propeptide of Type 1 procollagen

NTX:

N-telopeptide

SGBG:

Sex hormone binding globulin

SD:

Standard deviation

SE:

Standard error

CV:

Coefficient of variation

References

  • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition – Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Publishing, Inc.

  • Bostwick, J. R., Guthrie, S. K., & Ellingrod, V. L. (2009). Antipsychotic-induced hyperprolactinemia. Pharmacotherapy, 29(1), 64–73.

    Article  PubMed  Google Scholar 

  • Carter, D. R., Bouxsein, M. L., & Marcus, R. (1992). New approaches for interpreting projected bone densitometry data. Journal of Bone and Mineral Research, 7(2), 137–145.

    Article  PubMed  Google Scholar 

  • CDC. (2009). Prevalence of autism spectrum disorders—autism and developmental disabilities monitoring network, United States, 2006. MMWR Surveillance Summary, 58(10), 1–20.

    Google Scholar 

  • Chou, I. J., Lin, K. L., Wang, H. S., & Wang, C. J. (2007). Evaluation of bone mineral density in children receiving carbamazepine or valproate monotherapy. Acta Paediatrics of Taiwan, 48(6), 317–322.

    Google Scholar 

  • Davies, J. H., Evans, B. A., & Gregory, J. W. (2005). Bone mass acquisition in healthy children. Archives of Disease in Childhood, 90(4), 373–378.

    Article  PubMed  Google Scholar 

  • Foo, L. H., Zhang, Q., Zhu, K., Ma, G., Hu, X., Greenfield, H., et al. (2009). Low vitamin D status has an adverse influence on bone mass, bone turnover, and muscle strength in Chinese adolescent girls. Journal of Nutrition, 139(5), 1002–1007.

    Article  PubMed  Google Scholar 

  • Greaves-Lord, K., Huizink, A. C., Oldehinkel, A. J., Ormel, J., Verhulst, F. C., & Ferdinand, R. F. (2009). Baseline cortisol measures and developmental pathways of anxiety in early adolescence. Acta Paediatrica Scandinavia, 120(3), 178–186.

    Article  Google Scholar 

  • Greulich, W., & Pyle, S. (1959). Radiographic atlas of skeletal development of the hand and wrist (2nd ed.). Stanford: Stanford University Press.

    Google Scholar 

  • Grey, V., Atkinson, S., Drury, D., Casey, L., Ferland, G., Gundberg, C., et al. (2008). Prevalence of low bone mass and deficiencies of vitamins D and K in pediatric patients with cystic fibrosis from 3 Canadian centers. Pediatrics, 122(5), 1014–1020.

    Article  PubMed  Google Scholar 

  • Hediger, M. L., England, L. J., Molloy, C. A., Yu, K. F., Manning-Courtney, P., & Mills, J. L. (2008). Reduced bone cortical thickness in boys with autism or autism spectrum disorder. Journal of Autism and Developmental Disorders, 38(5), 848–856.

    Article  PubMed  Google Scholar 

  • Heyman, R., Guggenbuhl, P., Corbel, A., Bridoux-Henno, L., Tourtelier, Y., Balencon-Morival, M., et al. (2009). Effect of a gluten-free diet on bone mineral density in children with celiac disease. Gastroenterologie Clinique et Biologique, 33(2), 109–114.

    Article  PubMed  Google Scholar 

  • Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 96(7), 1911–1930.

    Article  PubMed  Google Scholar 

  • Horvath, K., Papadimitriou, J. C., Rabsztyn, A., Drachenberg, C., & Tildon, J. T. (1999). Gastrointestinal abnormalities in children with autistic disorder. Journal of Pediatrics, 135(5), 559–563.

    Article  PubMed  Google Scholar 

  • Kushak, R. I., Lauwers, G. Y., Winter, H. S., & Buie, T. M. (2011). Intestinal disaccharidase activity in patients with autism: Effect of age, gender, and intestinal inflammation. Autism, 15(3), 285–294.

    Article  PubMed  Google Scholar 

  • Leder, B. Z., LeBlanc, K. M., Schoenfeld, D. A., Eastell, R., & Finkelstein, J. S. (2003). Differential effects of androgens and estrogens on bone turnover in normal men. Journal of Clinical Endocrinology and Metabolism, 88(1), 204–210.

    Article  PubMed  Google Scholar 

  • Lehtonen-Veromaa, M. K., Mottonen, T. T., Nuotio, I. O., Irjala, K. M., Leino, A. E., & Viikari, J. S. (2002). Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: A 3-y prospective study. American Journal of Clinical Nutrition, 76(6), 1446–1453.

    PubMed  Google Scholar 

  • Lopez-Duran, N. L., Kovacs, M., & George, C. J. (2009). Hypothalamic-pituitary-adrenal axis dysregulation in depressed children and adolescents: A meta-analysis. Psychoneuroendocrinology, 34(9), 1272–1283.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.

    Article  PubMed  Google Scholar 

  • Michael, H., Harkonen, P. L., Vaananen, H. K., & Hentunen, T. A. (2005). Estrogen and testosterone use different cellular pathways to inhibit osteoclastogenesis and bone resorption. Journal of Bone and Mineral Research, 20(12), 2224–2232.

    Article  PubMed  Google Scholar 

  • Ming, X., Brimacombe, M., & Wagner, G. C. (2007). Prevalence of motor impairment in autism spectrum disorders. Brain Dev, 29(9), 565–570.

    Article  PubMed  Google Scholar 

  • Misra, M., Aggarwal, A., Miller, K. K., Almazan, C., Worley, M., Soyka, L. A., et al. (2004). Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics, 114(6), 1574–1583.

    Article  PubMed  Google Scholar 

  • Misra, M., Pacaud, D., Petryk, A., Collett-Solberg, P. F., & Kappy, M. (2008). Vitamin D deficiency in children and its management: Review of current knowledge and recommendations. Pediatrics, 122(2), 398–417.

    Article  PubMed  Google Scholar 

  • Ogden, C., Kuczmarski, R., Flegal, K., Mei, Z., Guo, S., Wei, R., et al. (2002). Centers for Diseases Control and Prevention 2000 growth charts for the United States: Improvements to the 1997 National Center for health Statistics version. Pediatrics, 109, 45–60.

    Article  PubMed  Google Scholar 

  • Pack, A. M., Morrell, M. J., Randall, A., McMahon, D. J., & Shane, E. (2008). Bone health in young women with epilepsy after one year of antiepileptic drug monotherapy. Neurology, 70(18), 1586–1593.

    Article  PubMed  Google Scholar 

  • Pan, C. Y. (2008). Objectively measured physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan. Journal of Autism and Developmental Disorders, 38(7), 1292–1301.

    Article  PubMed  Google Scholar 

  • Ragusa, L., Elia, M., & Scifo, R. (1993). Growth hormone deficit in autism. Journal of Autism and Developmental Disorders, 23(2), 421–422.

    Article  PubMed  Google Scholar 

  • Russell, M., Breggia, A., Mendes, N., Klibanski, A., & Misra, M. (2011). Growth hormone is positively associated with surrogate markers of bone turnover during puberty. Clinical Endocrinology (Oxford), 75(4), 482–488.

    Article  Google Scholar 

  • Schmidt, S., Mellstrom, D., Norjavaara, E., Sundh, S. V., & Saalman, R. (2009). Low bone mineral density in children and adolescents with inflammatory bowel disease: A population-based study from Western Sweden. Inflammatory Bowel Diseases, 15(12), 1844–1850.

    Article  PubMed  Google Scholar 

  • Sheth, R. D., Binkley, N., & Hermann, B. P. (2008). Progressive bone deficit in epilepsy. Neurology, 70(3), 170–176.

    Article  PubMed  Google Scholar 

  • Slomski, A. (2011). IOM endorses vitamin D, calcium only for bone health, dispels deficiency claims. JAMA, 305(5), 453–454, 456.

    Google Scholar 

  • Soyka, L. A., Grinspoon, S., Levitsky, L. L., Herzog, D. B., & Klibanski, A. (1999). The effects of anorexia nervosa on bone metabolism in female adolescents. Journal of Clinical Endocrinology and Metabolism, 84(12), 4489–4496.

    Article  PubMed  Google Scholar 

  • Valicenti-McDermott, M. D., McVicar, K., Cohen, H. J., Wershil, B. K., & Shinnar, S. (2008). Gastrointestinal symptoms in children with an autism spectrum disorder and language regression. Pediatric Neurology, 39(6), 392–398.

    Article  PubMed  Google Scholar 

  • Wren, T. A., Liu, X., Pitukcheewanont, P., & Gilsanz, V. (2005). Bone acquisition in healthy children and adolescents: Comparisons of dual-energy X-ray absorptiometry and computed tomography measures. Journal of Clinical Endocrinology and Metabolism, 90(4), 1925–1928.

    Article  PubMed  Google Scholar 

  • Zemel, B. S., Kalkwarf, H. J., Gilsanz, V., Lappe, J. M., Oberfield, S., Shepherd, J. A., et al. (2011). Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: Results of the bone mineral density in childhood study. Journal of Clinical Endocrinology and Metabolism, 96(10), 3160–3169.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported in part by NIH grants 1 UL1 RR025758-01 and as part of the Autism Speaks Autism Treatment Network. Further support came from a cooperative agreement (UA3 MC 11054) from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program, to the Massachusetts General Hospital, and in partnership with the Lurie Center for Autism. The views expressed in this publication do not necessarily reflect the views of Autism Speaks, Inc. We are grateful to our colleagues Drs. Susan McGrew and Cynthia Molloy for their collaboration and help in setting up this project, and Drs. Susan McGrew and James Perrin for their help in preparation of this manuscript. We would also like to thank Dr. Christopher McDougle for his helpful comments in the revision of this manuscript.

Author information

Authors and Affiliations

  1. Lurie Center for Autism, Massachusetts General Hospital and Harvard Medical School, One Maguire Road, Lexington, MA, 02421, USA

    Ann M. Neumeyer

  2. Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA

    Hang Lee

  3. Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA

    Madhusmita Misra

  4. Lurie Center for Autism, Massachusetts General Hospital, One Maguire Road, Lexington, MA, 02421, USA

    Amy Gates & Christine Ferrone

Authors
  1. Ann M. Neumeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy Gates
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christine Ferrone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hang Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Madhusmita Misra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ann M. Neumeyer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Neumeyer, A.M., Gates, A., Ferrone, C. et al. Bone Density in Peripubertal Boys with Autism Spectrum Disorders. J Autism Dev Disord 43, 1623–1629 (2013). https://doi.org/10.1007/s10803-012-1709-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-012-1709-3

Keywords

Search

Navigation