Salivary testosterone in male and female youth with and without autism spectrum disorder: considerations of development, sex, and diagnosis.
Rachael A Muscatello, Emma Rafatjoo, Karan K Mirpuri and 3 others
PMID 36123716WHAT IT FOUND
Morning salivary testosterone was higher in adolescents with autism than in typically developing peers, but this difference disappeared once pubertal stage was accounted for.
Age and puberty were the strongest predictors of testosterone levels, not diagnosis. Testosterone showed no link to social symptom severity.
Key findings
01Adolescents with ASD had significantly higher morning salivary testosterone levels than typically developing peers in initial models.
02The difference in testosterone between ASD and typically developing youth was no longer significant when pubertal stage was included in the analysis.
03Testosterone levels did not predict social symptom severity, and social symptoms did not predict testosterone levels.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was not representative of the broader autism spectrum, requiring an IQ of 70 or higher and excluding those with known genetic etiologies. The male-to-female ratio was unequal in the ASD group (25.7% female) compared to the TD group (44.2% female), which may affect sex-based comparisons. The assay's detection limit was too high to measure afternoon and evening testosterone, restricting analysis to morning samples only. The study design was cross-sectional at one time point, so it cannot determine if testosterone levels change differently over time in ASD versus TD youth beyond age and puberty effects.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that testosterone levels are a biomarker for autism or social impairment. The apparent elevation in ASD disappeared when pubertal stage was controlled for, and there was no link between testosterone and social symptom severity.