Bone Health and BMD Research in Pediatric and Adolescent Individuals with ASD: Current Data, Evaluation, and Next Steps

Abstract

Austin spectrum disorder (ASD) is a complex neurodevelopmental disorder that can include impairments in communication skills and social interaction as well as behavioral challenges. Recent research has evaluated bone health and bone mineral density (BMD) in cohorts of pediatric, adolescent, and young adult participants. Consistent findings across publications indicate that individuals with ASD have decreased BMD when compared to non-ASD age-matched peers. Factors raised in the literature for consideration of impact on BMD status include dietary intake, feeding behavior, nutrient status, gastrointestinal (GI) symptoms and diagnoses, physical activity, and prescription medication usage. This review aims to provide a comprehensive overview of published research evaluating BMD in those with ASD, analyze potential issues of correlation with lowered BMD in this population, offer perspective for future research consideration, and propose evaluation and intervention strategies to address and potentially ameliorate both the short-term and long-term impact of decreased BMD in children and adolescents.

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Abbreviations

ASD:

autism spectrum disorder

BMC:

bone mineral content

BMD:

BMD

DEXA:

dual-energy X-ray absorptiometry

GFCF:

gluten free casein free

IBD:

inflammatory bowel disease

PCP:

primary care practitioner

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KB designed and organized this review. MD completed literature searches, the first draft of the manuscript was written by KB, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kelly M. Barnhill.

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Barnhill, K.M., Devlin, M. & Hewitson, L. Bone Health and BMD Research in Pediatric and Adolescent Individuals with ASD: Current Data, Evaluation, and Next Steps. Clinic Rev Bone Miner Metab 17, 160–169 (2019). https://doi.org/10.1007/s12018-019-09268-w

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Keywords

  • BMD
  • Bone mineral density
  • Autism spectrum disorder
  • ASD