Hyperuricemia in Children and Adolescents with Autism Spectrum Disorder Treated with Risperidone: The Risk Factors for Metabolic Adverse Effects

Abstract

Background: Atypical antipsychotics have been found to be associated with hyperuricemia. Risperidone, one of the atypical antipsychotics, might be related to the hyperuricemia among autism spectrum disorder (ASD) patients. The aims of this study were to determine the prevalence of hyperuricemia in ASD patients treated with risperidone and to determine associations between serum uric acid levels and risperidone dosage, treatment duration, and metabolic parameters.Methods: 127 children and adolescents with ASD treated with risperidone and 76 age-matched risperidone-naïve patients with ASD were recruited. The clinical data and laboratory data were analyzed. Hyperuricemia was defined as serum uric acid >5.5 mg/dl.Results: Hyperuricemia was present in 44.70% of risperidone-naïve patients with ASD and 57.50% of ASD patients treated with risperidone. The fasting uric acid levels were significantly higher in the risperidone group than in the risperidone-naïve group (5.70 vs. 5.35 mg/dl, P = 0.01). The increased uric acid concentrations were significantly associated with adolescent patients treated with risperidone. The higher dose of risperidone and/or the longer treatment time were associated with the increased uric acid levels. Uric acid levels significantly rose with body mass index (BMI), waist circumference (WC), triglyceride (TG) levels, triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C), insulin levels, homeostatic model assessment index (HOMA-IR), high-sensitivity CRP (hs-CRP) levels, and leptin levels. Conversely, the levels of HDL-C and adiponectin were negatively correlated with uric acid levels. In multiple regression analysis, there were age, BMI, TG/HDL-C ratio, and adiponectin levels remained significantly associated with uric acid levels.Conclusion: Hyperuricemia may play a role in metabolic adverse effect in children and adolescents with ASDs receiving the high dose and/or the long-term treatment with risperidone.

Risperidone Exacerbates Glucose Intolerance, Nonalcoholic Fatty Liver Disease, and Renal Impairment in Obese Mice

“…Similar to other works, we found that risperidone administration induced renal damage [ 20 , 63 , 64 ]. Under hyperglycemic conditions induced to simulate the risk factors for risperidone, risperidone-treated mice exhibited a reduction of antioxidative defense enzymes in the kidneys.…”

Prevalence of hyperuricemia and its related risk factors among preschool children from China

“…A cross-sectional analysis using data from the Nation Health and Nutrition Examination Survey(NHANES)1999–2002 reported that the mean concentration of uric acid among children and adolescents aged 12 to 17 years was 301.9 μmol/L (5.1 mg/dL), and the percentage of serum uric acid ≥ 327 μmol/L (5.5 mg/dL) was 30.2% 10 . Another study reported that the median serum uric acid level in risperidone-naïve children and adolescents with Autism Spectrum Disorder was 5.35 mg/dL and the prevalence of hyperuricemia (>5.5 mg/dL) was 44.70%, higher than normal children and adolescent 12 . The mean serum uric acid level of children aged less than 7 years in our study was 243.0 μmol/L (4.1 mg/dL), which was a little higher than that of Hispanic children aged 5 years (3.9 ± 0.8 mg/dL), but lower than previous results of the NHANES study and risperidone-naïve children and adolescents with Autism Spectrum Disorder 10 , 12 , 13 .…”

“…Another study reported that the median serum uric acid level in risperidone-naïve children and adolescents with Autism Spectrum Disorder was 5.35 mg/dL and the prevalence of hyperuricemia (>5.5 mg/dL) was 44.70%, higher than normal children and adolescent 12 . The mean serum uric acid level of children aged less than 7 years in our study was 243.0 μmol/L (4.1 mg/dL), which was a little higher than that of Hispanic children aged 5 years (3.9 ± 0.8 mg/dL), but lower than previous results of the NHANES study and risperidone-naïve children and adolescents with Autism Spectrum Disorder 10 , 12 , 13 . Civantos Modino, S. et al .…”

Pharmacogenetics of Risperidone‐Induced Insulin Resistance in Children and Adolescents with Autism Spectrum Disorder

“…For example, patients prescribed SGA drugs often show greater improvement in negative and cognitive symptoms, higher functional capacity, and have better quality of life with lower risks of extrapyramidal side effects (EPS) and tardive dyskinesia (TD) . However, some concerns exist about treatment with risperidone as it may induce side effects such as hyperprolactinaemia , hyperuricaemia , weight gain and dyslipidaemia . Additionally, risperidone could increase the risk of type 2 diabetes .…”