Association between autism spectrum disorder and diabetes: systematic review and meta-analysis

Samuele Cortese; Alessandra Gabellone; Lucia Marzulli; Iciar Iturmendi-Sabater; Diego de La Chica-Duarte; Isabella M Piqué; Marco Solmi; Jae Il Shin; Lucia Margari; Gonzalo Arrondo

doi:10.1016/j.neubiorev.2022.104592

Association between autism spectrum disorder and diabetes: systematic review and meta-analysis

Neurosci Biobehav Rev. 2022 May:136:104592. doi: 10.1016/j.neubiorev.2022.104592. Epub 2022 Feb 22.

Affiliations

¹ Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
² Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
³ School of Education and Psychology, University of Navarra, Pamplona, Spain; Division of Psychology and Language Sciences University College London, London, UK; Institute of Medical Science, University of Toronto, Toronto, Canada.
⁴ School of Education and Psychology, University of Navarra, Pamplona, Spain.
⁵ School of Education and Psychology, University of Navarra, Pamplona, Spain; Facultad de Ciencias Biomédicas, Universidad Austral, Pilar, Argentina; Centro de Desarrollo y Fortalecimiento de la Niñez, Adolescencia y Familia Dr. Ramón Carrillo, San Isidro, Argentina.
⁶ Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada.
⁷ Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea.
⁸ Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Mind-Brain Group, Institute for Culture and Society, University of Navarra, Pamplona, Spain. Electronic address: garrondo@unav.es.

PMID: 35217107
DOI: 10.1016/j.neubiorev.2022.104592

Abstract

There is mixed evidence on the link between autism spectrum disorder (ASD) and diabetes. We conducted the first systematic review/meta-analysis on their association. Based on a pre-registered protocol (PROSPERO: CRD42021261114), we searched Pubmed, Ovid, and Web of Science databases up to 6 December 2021, with no language/type of document restrictions. We assessed study quality using the Newcastle-Ottawa Scale (NOS). We included 24 studies (total: 3427,773 individuals; 237,529 with ASD and 92,832 with diabetes) in the systematic review and 20 in the meta-analysis (mean stars number on the NOS: 5.89/10). There was a significant association, albeit characterized by significant heterogeneity, when pooling unadjusted OR (1.535, 95% CI = 1.109-2.126), which remained significant when restricting the analysis to children and type 2 diabetes, but became non-significant when considering adjusted ORs (OR: 1.528, 95% CI = 0.954-2.448). No significant prospective association was found (n = 2) on diabetes predicting ASD (HR: 1.232, 0.826-11.837). Therefore, the association between ASD and diabetes is likely confounded by demographic and clinical factors that should be systematically investigated in future studies.

Keywords: Autism; Diabetes; Meta-analysis.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Autism Spectrum Disorder* / complications
Child
Diabetes Mellitus, Type 2* / complications
Humans