CohortJournal of autism and developmental disorders2019

Cord and Early Childhood Plasma Adiponectin Levels and Autism Risk: A Prospective Birth Cohort Study.

Ramkripa Raghavan, M Daniele Fallin, Xiumei Hong and 5 others

PMID 30043356

WHAT IT FOUND

Children later diagnosed with autism had lower cord blood adiponectin.

Higher cord levels were linked to lower autism risk, while early childhood levels were less consistent. This observational study cannot show cause.

Key findings

01Higher cord adiponectin levels were associated with lower ASD risk (OR: 0.51; 95% CI: 0.35, 0.75).

02After adjustment, the highest cord adiponectin quartile was associated with adjusted odds of 0.14 for ASD (95% CI: 0.04, 0.46).

03Early childhood adiponectin was not associated with ASD risk in the unadjusted model (OR: 0.71; 95% CI: 0.45, 1.13), and the adjusted association was no longer significant after accounting for cord adiponectin.

STILL TO COME

How it was doneWhat they found

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What it does not show

The analysis included 674 children for cord adiponectin and 638 children for early childhood adiponectin, leaving only 40 children with ASD in the cord analysis and 36 in the early childhood analysis, so estimates may be unstable. ASD diagnosis was identified from electronic medical records, which can misclassify outcomes. The study was observational, and the authors describe the findings as hypothesis generating rather than evidence for clinical use. The cohort was primarily urban, low-income minority and enriched for preterm birth, so the results may not generalise to other populations. Only total adiponectin was measured, not separate adiponectin forms. The early childhood association was weakened after adjusting for cord adiponectin. Even after adjusting for known risk factors, residual confounding is possible.

Declared interests

The authors declared no conflict of interest pertaining to this work.

The easy way to misread this

Do not conclude that low cord adiponectin causes autism or that adiponectin testing can identify children at risk. The study is observational, the ASD sample was small, and the authors state the findings are hypothesis generating.

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The study

Participants
847 mother-child pairs; 674 children were included in the cord adiponectin analysis and 638 in the early childhood analysis
Certainty of evidence
Low

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    Ramkripa Raghavan, M Daniele Fallin, Xiumei Hong, et al. Cord and Early Childhood Plasma Adiponectin Levels and Autism Risk: A Prospective Birth Cohort Study. Journal of autism and developmental disorders. 2019.

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