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Fetal and Infancy Growth Pattern, Cord and Early Childhood Plasma Leptin, and Development of Autism Spectrum Disorder
Ramkripa Raghavan1, Barry Zuckerman2, Xiumei Hong1
1Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Insights
Rapid infant weight gain and higher early childhood leptin levels are associated with increased autism spectrum disorder (ASD) risk. Leptin may mediate the link between rapid growth and ASD, suggesting potential for early detection.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Endocrinology
Background:
- Leptin, a proinflammatory cytokine, is crucial for energy homeostasis.
- Altered leptin levels and rapid early growth are potential factors in autism spectrum disorder (ASD).
- Prospective studies on leptin, growth patterns, and ASD risk are limited.
Purpose of the Study:
- To investigate the association between cord and early childhood leptin levels and ASD risk.
- To examine the relationship between infant weight gain, birth weight, and ASD.
- To assess leptin's mediating role in the association between infant weight gain and ASD.
Main Methods:
- Prospective cohort study of 822 subjects from the Boston Birth Cohort.
- ASD diagnosis based on electronic medical record codes.
- Measurement of cord and early childhood leptin levels, birth weight for gestational age, and infant weight gain.
Main Results:
- Extremely rapid infant weight gain was associated with significantly increased ASD risk (aOR: 3.11).
- Higher early childhood leptin levels were linked to increased ASD risk (aOR: 7.87).
- Leptin mediated the relationship between rapid infant weight gain and ASD; no association found for cord leptin or birth weight for gestational age.
Conclusions:
- Rapid infant growth and elevated early childhood leptin are associated with higher ASD risk.
- Leptin may play a mediating role in the link between early life growth patterns and ASD.
- Combined assessment of growth patterns and biomarkers like leptin may aid in earlier ASD prediction.
Abstract:
Leptin is a proinflammatory cytokine that plays an important role in energy homeostasis. Emerging evidence suggests that leptin levels are altered in children with autism spectrum disorder (ASD); however, this has not been studied prospectively. Rapid growth during infancy and early childhood has been implicated in ASD, but the evidence is inconsistent. As leptin is involved in growth and is a potential risk factor for ASD, we explored the associations between (a) cord, early childhood leptin and ASD; and (b) birth weight for gestational age, early childhood weight gain, and ASD. We also assessed the mediating role of leptin in the relationship between weight gain during infancy and ASD. This study was conducted in a sample of 822 subjects from the Boston Birth Cohort. ASD was defined from diagnostic codes in electronic medical records. Extremely rapid weight gain during infancy was associated with a greater ASD risk and this persisted after adjusting for potential confounders (aOR: 3.11; 95% CI: 1.37, 7.07). Similarly, children that had higher plasma leptin levels, prior to ASD diagnosis, had an increased ASD risk in both unadjusted and adjusted models (aOR: 7.87; 95% CI: 2.06, 30.04). Further, early childhood leptin indirectly mediated the relationship between rapid weight gain and ASD. No associations were found between birth weight for gestational age, cord leptin and risk of ASD. Our findings provide a basis to further explore whether the combination of early life growth pattern and a biomarker such as leptin can predict ASD earlier. Autism Res 2018, 11: 1416-1431. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Is early life growth and a biomarker leptin related to ASD risk? To answer this question, we followed 822 children from birth and found that those who gained weight very quickly in infancy, had higher leptin levels in early childhood, had a greater chance of later ASD diagnosis. More research is needed to see if infant's weight gain pattern along with a biomarker (such as leptin) can be used to identify children with ASD sooner.
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