Metabolic syndrome in adults with autistic traits: associated psychological, behavioural, and biological factors in females and males

While cardiovascular diseases are an important cause of morbidity and mortality in autistic adults, knowledge on factors associated with their increased cardiovascular risk is limited. Therefore, the aim of this study is to examine psychological, behavioural, and physical factors associated with metabolic syndrome (MetS) in adults with autistic traits.
We included 17,705 adults from the Lifelines Cohort, categorized using Autism Spectrum Quotient-10 sum-scores. The quartiles with highest (HQ-traits-group females: n=2635; males: n=1803) and lowest levels of autistic traits (LQ-traits-group, n=idem) were analysed. Using multivariable logistic regression, the associations between MetS and psychological, behavioural (questionnaire-assessed), and physically measured factors in these stratified groups were investigated.
Among females, MetS was more common in the HQ-traits-group than in the LQ-traits-group (10.0% versus 7.5%, p<0.01), while this was not the case among males (HQ-traits-group 13.8% versus LQ-traits-group 13.1%, p=0.52). In both the female and male HQ-traits-group, the presence of MetS was strongly associated with lower perceived health, less physical activity, and altered leukocyte counts.
These findings highlight the importance of adequate cardiovascular prevention in adults with higher levels of autistic traits. Future research could gain more insight into the correlation between autistic traits in females and cardiovascular risk, and into tailored cardiovascular prevention.