Section of Developmental and Behavioral Sciences, Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, USA.
J Dev Behav Pediatr. 2012 Oct;33(8):618-24. doi: 10.1097/DBP.0b013e318260943c.
Fractures and pain, secondary to low bone mineral density (BMD), have been reported in pediatric patients with autistic spectrum disorders (ASD). The purpose of this study was to assess the BMD of a clinical sample of 10- to 18-year olds with ASD, and the nutrition and physical activity correlates of skeletal health in this population.
Twenty-six patients with ASD were recruited from an outpatient multidisciplinary child-development clinic. Lumbar bone density was measured using dual-energy x-ray absorptiometry. Data collection included anthropometries, serum nutrient levels, parent interview, and 72-hour diet, screen-time, and physical activity records.
Four patients (15%) met criteria for pediatric low BMD with z scores less than or equal to -2.0; another 4 were at risk with z scores less than or equal to -1.0. Approximately 54% of participants had insufficient serum 25-hydroxy vitamin D. Mean electronic media use was 251 minutes/day; mean physical activity 69 minutes/day. Fewer than 50% of participants met daily reference intake of vitamins A, B3, D, E, K, zinc, calcium, folate, potassium, and fiber. Bone density correlated positively with body mass (r = .47), calcium intake (r = .46), and calorie intake (r = .58).
Children aged 10 to 18 years old with ASD are at risk for occult low bone density. In this study, those with low body mass index and insufficient calcium and calorie intake were at greater risk. Other unhealthy behaviors in this population included a high screen-time to physical activity ratio and multiple nutrient deficiencies.
据报道，患有自闭症谱系障碍（ASD）的儿科患者存在因低骨密度（BMD）引起的骨折和疼痛。本研究的目的是评估 10-18 岁 ASD 临床样本的 BMD，以及该人群骨骼健康的营养和身体活动相关性。
从一家多学科儿童发育门诊招募了 26 名 ASD 患者。使用双能 X 射线吸收法测量腰椎骨密度。数据收集包括人体测量学、血清营养水平、家长访谈以及 72 小时饮食、屏幕时间和体力活动记录。
4 名患者（15%）符合小儿低 BMD 标准，Z 分数小于或等于-2.0；另外 4 名患者存在 Z 分数小于或等于-1.0 的风险。约 54%的参与者血清 25-羟维生素 D 不足。平均电子媒体使用时间为 251 分钟/天；平均体力活动时间为 69 分钟/天。少于 50%的参与者满足维生素 A、B3、D、E、K、锌、钙、叶酸、钾和纤维的每日参考摄入量。骨密度与体重（r =.47）、钙摄入量（r =.46）和卡路里摄入量（r =.58）呈正相关。
10-18 岁 ASD 儿童存在隐性低骨密度风险。在这项研究中，体重指数低、钙和卡路里摄入不足的儿童风险更大。该人群的其他不健康行为包括高屏幕时间与体力活动比例和多种营养缺乏。
