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Meta-Analysis
. 2017 Sep 15;7(1):11697.
doi: 10.1038/s41598-017-12003-4.

Association among obesity, overweight and autism spectrum disorder: a systematic review and meta-analysis

Zhen Zheng  1   2 , Li Zhang  1   2 , Shiping Li  1   2 , Fengyan Zhao  1   2 , Yan Wang  1   2 , Lan Huang  1   2 , Jinglan Huang  1   2 , Rong Zou  1   2 , Yi Qu  1   2 , Dezhi Mu  3   4
Affiliations
Meta-Analysis

Association among obesity, overweight and autism spectrum disorder: a systematic review and meta-analysis

Zhen Zheng et al. Sci Rep. .

Abstract

Obesity, overweight and autism spectrum disorder (ASD) remain serious public health problems. Although lots of studies have recently explored the association among obesity, overweight and ASD, the findings are inconsistent. Thus, we conducted a meta-analysis of epidemiological studies to examine the association among obesity, overweight and ASD. PubMed, Embase, and the Cochrane Library were used for literature searches to identify eligible studies published in English before November 15, 2016. Relevant studies estimating the association among obesity, overweight and ASD were included. Fifteen studies encompassing 49,937,078 participants and 1,045,538 individuals with ASD were included in this study. A random effects model was chosen to synthesize the effect sizes of individual studies. The prevalence of obesity was significantly higher in individuals with ASD than in controls (OR = 1.84, 95% confidence interval [CI]: 1.37-2.48, P < 0.001). However, the prevalence of overweight in individuals with ASD was not significantly different from that in controls (OR = 1.07, 95% CI: 0.83-1.38, P = 0.62). Both sensitivity analysis and publication bias testing revealed that the findings were robust. The meta-analysis showed a significant association between obesity and ASD. However, no significant association was identified between overweight and ASD.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the literature search. A total of 2,720 potential studies were initially identified in databases. 72 studies were identified after excluding 421 duplicate studies, 2,177 irrelevant studies, 6 reviews and 44 letters/meetings. Then, 57 studies were removed after a careful screening. Ultimately, 15 studies were adopted in this meta-analysis.
Figure 2
Figure 2
Forest plot of odds ratios for the association between obesity and ASD. Fourteen studies encompassing 1,045,485 individuals with ASD and 48,891,482 controls were included. The prevalence of obesity was higher in individuals with ASD than in controls. There was a significant association between obesity and ASD.
Figure 3
Figure 3
Forest plot of odds ratios for the association between overweight and ASD. Thirteen articles encompassing 995,269 individuals with ASD and 48,632,660 controls were included. The prevalence of overweight was not significantly different between individuals with ASD and controls. There was no significant association between overweight and ASD.
Figure 4
Figure 4
Funnel plot of the association between obesity and ASD. The pooled effect size is shown on the horizontal line. The expected 95% confidence interval for a given standard error is shown by the angled lines. The funnel plot showed potential publication bias.
Figure 5
Figure 5
Funnel plot of the association between overweight and ASD. The pooled effect size is shown on the horizontal line. The expected 95% confidence interval for a given standard error is shown by the angled lines. The funnel plot showed potential publication bias.
See this image and copyright information in PMC

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