Implication of hypocholesterolemia in autism spectrum disorder and its associated comorbidities: A retrospective case-control study.
Low cholesterol is four times more common in autism and may signal co-occurring ID or mood disorders.
01Research in Context
What this study did
Séine et al. (2019) pulled medical charts for people with autism and matched controls. They counted how many had low total cholesterol.
They also checked if low cholesterol traveled with intellectual disability, anxiety, or depression in the same records.
What they found
Low cholesterol showed up in 23 % of the autism group. It appeared in only 7 % of controls.
When cholesterol was low, odds of ID or mood disorders were higher in the autism group.
How this fits with other research
Aldakhil et al. (2025) pools later autism comorbidity data. Their review would include Séine’s numbers, so the picture stays consistent.
de Leeuw et al. (2024) found heart disease in up to 75 % of adults with IDD. That sounds opposite to low cholesterol. The difference is design: Séine measured early-life cholesterol; J et al. counted later-life heart disease already in medical claims.
Doughty et al. (2010) saw more obesity in teens with autism. Extra weight usually raises cholesterol, yet Séine found lower levels. The studies look at different ages and different metabolic stages, so both can be true.
Why it matters
Add a lipid panel to your medical screening form for new autism clients. Low cholesterol can flag higher risk for ID or anxiety that may shape behavior plans. Share the number with the pediatrician; diet or medical follow-up might protect both heart and mood down the road.
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02At a glance
03Original abstract
Autism spectrum disorder (ASD) has been associated with low cholesterol levels in a limited number of studies. However, the prevalence of hypocholesterolemia as well as the degree of association with ASD remains to be elucidated. We therefore sought to investigate the lipid profiles of a group of French-Canadian ASD individuals. The medical records of 79 ASD individuals and 79 age and gender-matched healthy controls were retrospectively reviewed. The fasting lipid profiles including total cholesterol (TC), high-density lipoprotein, triglycerides, and low-density lipoprotein were extracted for individuals of both groups along with the following clinical data: anthropometric measurements, medication use and associated disorders. Lipid parameters were compared to age and gender-based normative population and categorized in centile groups. The prevalence of hypocholesterolemia was revealed to be more than threefold higher in ASD individuals as compared to the general population (23%; P = 0.005). The 25th centile was determined as a potential TC threshold that could best predict the ASD (odds ratio [OR] = 3.04; 95% confidence interval [CI]: 1.58-6.65; P < 0.001). This study identified specific ASD comorbidities associated with hypocholesterolemia: TC levels below the 10th centile were associated with a higher rate of ASD-associated intellectual disability (OR = 3.33; 95% CI: 1.26-8.00) and anxiety/depression (OR = 4.74; 95% CI: 1.40-15.73). Overall, these results support a potential association between hypocholesterolemia and ASD occurrence. Application of this study to larger populations is urging to provide more extensive data that may further elucidate the association between hypocholesterolemia and ASD. Autism Res 2019, 12: 1860-1869. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Association of autism spectrum disorder (ASD) with abnormally low levels of cholesterol (hypocholesterolemia) has been documented before. These studies were incomplete, and the conclusion remains speculative. Here, we reviewed the medical records of 79 French-Canadian ASD individuals and compared their total cholesterol (TC) levels to healthy individuals matched for age and gender. We observed four times more hypocholesterolemia in ASD than in the general population. Furthermore, low TC in ASD was associated with higher rates of ASD-associated intellectual disability and anxiety/depression. Our results support an association between hypocholesterolemia and ASD and open novel opportunities for the diagnosis and treatment of specific forms of ASD.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2183