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This nationwide cohort study examined sex\u2010stratified incidence of physical illnesses within 5\u00a0years after autism spectrum disorder (ASD) diagnosis in children \u22645\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Taiwan's National Health Insurance Research Database (2000\u20132019), we identified 36,656 autistic males and 9024 autistic females newly diagnosed before age 6 and followed for five years. Adjusted odds ratios and hazard ratios for physical illnesses were estimated via multivariate logistic and Cox regression, controlling for demographic, clinical, and healthcare utilization factors. Analyses were stratified by intellectual disability status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Within 5\u00a0years following an ASD diagnosis, autistic females exhibited higher incidences of cardiovascular diseases, cerebrovascular diseases, epilepsy, and irritable bowel syndrome, with generally modest to moderate effect sizes (approximately 1.3\u20132.3). In contrast, autistic males consistently demonstrated a higher risk of asthma. Prevalence analyses revealed similar patterns. Stratified analyses further indicated that, among children without intellectual disabilities, autistic females remained at elevated risks for cardiovascular diseases and epilepsy, with effect sizes ranging from approximately 1.44 to 2.86. Additional increased risks of hyperlipidemia and atopic dermatitis were also observed in autistic females, whereas autistic males continued to show higher risks of asthma and diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Autistic females in early childhood face greater cardiometabolic and neurological burdens, while males are more prone to respiratory and metabolic conditions. These sex\u2010 and cognition\u2010specific risk profiles support tailored screening\u2014cardiovascular\/metabolic monitoring for females and respiratory disease prevention for males\u2014to inform clinical care and health policy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcv2.70108","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T05:44:30Z","timestamp":1771566270000},"source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in 5\u2010year incidence and prevalence of physical illnesses following early childhood autism diagnosis"],"prefix":"10.1002","volume":"6","author":[{"given":"Yu\u2010Chieh","family":"Chuang","sequence":"first","affiliation":[{"name":"Taipei City Psychiatric Center Taipei City Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry School of Medicine College of 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