Cannell John J, Grant William B
Vitamin D Council; San Luis Obispo, CA USA.
Sunlight, Nutrition, and Health Research Center; San Francisco, CA USA.
Dermatoendocrinol. 2013 Jan 1;5(1):199-204. doi: 10.4161/derm.24356.
A growing body of literature suggests that higher serum 25-hydroxyvitamin D [25(OH)D] concentrations, either in utero or in early life, may reduce the risk of autism. For example, an ecological study in the companion paper inversely correlated solar UV-B doses in the United States with prevalence of autism among those aged 6-17 y. That study proposed that vitamin D deficiency during pregnancy could account for this finding, although the findings are also consistent with childhood vitamin D deficiency contributing to the condition. Also, in a recent study, children with autism had lower serum 25(OH)D concentrations than did control subjects (19 vs. 33 ng/ml), despite parents of each group reporting the same amount of sun exposure. The same study found highly significant inverse correlations between 25(OH)D and autism rating scales and between 25(OH)D and levels of an antineuronal antibody. This finding indicates that higher serum 25(OH)D concentrations may reduce the symptoms of established autism. Because activated vitamin D, a secosteroid, upregulates DNA-repair genes, vitamin D deficiency during development may inhibit the repair of de novo DNA mutations in fetuses and infants and thus contribute to risk of autism. Vitamin D might also reduce the risk or severity of autism through its anti-inflammatory actions, antiautoimmune effects, increasing seizure threshold, increasing T-regulatory cells, protecting the mitochondria, and upregulating glutathione, which scavenges oxidative by-products and chelates (captures and excretes) heavy metals. Vitamin D deficiency during pregnancy and childhood is a widespread and growing epidemic.
越来越多的文献表明,子宫内或生命早期较高的血清25-羟基维生素D [25(OH)D] 浓度可能会降低患自闭症的风险。例如,配套论文中的一项生态学研究将美国的太阳紫外线B剂量与6至17岁人群中的自闭症患病率进行了反向关联。该研究提出,孕期维生素D缺乏可能是这一发现的原因,尽管这一发现也与儿童期维生素D缺乏导致该病相符。此外,在最近的一项研究中,自闭症儿童的血清25(OH)D浓度低于对照组(分别为19 ng/ml和33 ng/ml),尽管两组父母报告的日照量相同。同一研究发现,25(OH)D与自闭症评定量表之间以及25(OH)D与抗神经元抗体水平之间存在高度显著的反向关联。这一发现表明,较高的血清25(OH)D浓度可能会减轻已确诊自闭症的症状。由于活性维生素D(一种甾体类化合物)可上调DNA修复基因,发育期间维生素D缺乏可能会抑制胎儿和婴儿中新生DNA突变的修复,从而增加患自闭症的风险。维生素D还可能通过其抗炎作用、抗自身免疫作用、提高癫痫阈值、增加调节性T细胞、保护线粒体以及上调谷胱甘肽(清除氧化副产物并螯合(捕获并排泄)重金属)来降低自闭症的风险或严重程度。孕期和儿童期维生素D缺乏是一种普遍且日益严重的流行病。