Atypical anti-psychotics have been found to be associated with hyperuricemia. The aims of this study were to determine the prevalence of hyperuricemia and metabolic adverse events in children and adolescents with ASD treated with risperidone.

In this cross-sectional study, we recruited 127 Thai ASD children and adolescents aged 3–20years receiving risperidone for more than 4 weeks. The clinical data and laboratory data were obtained and analyzed. Hyperuricemia was defined as serum uric acid>5.5mg/dL.

Hyperuricemia was present in 57.48% of total ASD patients treated with risperidone. Uric acid levels were significantly higher in adolescents as compared to children. Uric acid levels correlated with risperidone dose (P=0.01), duration of treatment (P<0.0001), BMI (P<0.0001), waist circumference (P=0.003), triglyceride (TG; P<0.0001), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-C; P<0.0001), insulin (P=0.04), homeostatic model assessment index (HOMA-IR; P=0.03), high-sensitivity CRP (hs-CRP; P<0.0001), and leptin levels (P<0.0001). HDL-C and adiponectin levels were negatively correlated with uric acid levels (P<0.0001). In multiple regressions analysis, age, BMI, TG/HDL-C, and adiponectin level remained significantly associated with uric acid levels (P<0.0001).

Hyperuricemia may play a role in metabolic adverse effects in children and adolescents with ASD receiving high dose and/or long-term treatment with risperidone.