Westmark Cara J
Department of Neurology, University of Wisconsin, Madison, Wisconsin, United States of America.
PLoS One. 2014 Mar 12;9(3):e80488. doi: 10.1371/journal.pone.0080488. eCollection 2014.
Seizures are a common phenotype in many neurodevelopmental disorders including fragile X syndrome, Down syndrome and autism. We hypothesized that phytoestrogens in soy-based infant formula were contributing to lower seizure threshold in these disorders. Herein, we evaluated the dependence of seizure incidence on infant formula in a population of autistic children. Medical record data were obtained on 1,949 autistic children from the SFARI Simplex Collection. An autism diagnosis was determined by scores on the ADI-R and ADOS exams. The database included data on infant formula use, seizure incidence, the specific type of seizure exhibited and IQ. Soy-based formula was utilized in 17.5% of the study population. Females comprised 13.4% of the subjects. There was a 2.6-fold higher rate of febrile seizures [4.2% versus 1.6%, OR = 2.6, 95% CI = 1.3-5.3], a 2.1-fold higher rate of epilepsy comorbidity [3.6% versus 1.7%, OR = 2.2, 95% CI = 1.1-4.7] and a 4-fold higher rate of simple partial seizures [1.2% versus 0.3%, OR = 4.8, 95% CI = 1.0-23] in the autistic children fed soy-based formula. No statistically significant associations were found with other outcomes including: IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures. Limitations of the study included: infant formula and seizure data were based on parental recall, there were significantly less female subjects, and there was lack of data regarding critical confounders such as the reasons the subjects used soy formula, age at which soy formula was initiated and the length of time on soy formula. Despite these limitations, our results suggest that the use of soy-based infant formula may be associated with febrile seizures in both genders and with a diagnosis of epilepsy in males in autistic children. Given the lack of data on critical confounders and the retrospective nature of the study, a prospective study is required to confirm the association.
癫痫发作是许多神经发育障碍中的常见表型，包括脆性X综合征、唐氏综合征和自闭症。我们推测，以大豆为基础的婴儿配方奶粉中的植物雌激素会导致这些疾病的癫痫阈值降低。在此，我们评估了自闭症儿童群体中癫痫发病率与婴儿配方奶粉的相关性。我们从SFARI单纯型病例集中获取了1949名自闭症儿童的病历数据。自闭症诊断由ADI-R和ADOS检查的分数确定。该数据库包括婴儿配方奶粉使用情况、癫痫发病率、癫痫发作的具体类型和智商的数据。17.5%的研究人群使用以大豆为基础的配方奶粉。女性占受试者的13.4%。食用以大豆为基础配方奶粉的自闭症儿童中，热性惊厥发生率高2.6倍[4.2%对1.6%，OR = 2.6，95%CI = 1.3 - 5.3]，癫痫合并症发生率高2.1倍[3.6%对1.7%，OR = 2.2，95%CI = 1.1 - 4.7]，简单部分性发作发生率高4倍[1.2%对0.3%，OR = 4.8，95%CI = 1.0 - 23]。未发现与其他结果有统计学显著关联，包括：智商、癫痫发作起始年龄、婴儿痉挛以及失张力性、全身性强直阵挛性、失神性和复杂部分性发作。该研究的局限性包括：婴儿配方奶粉和癫痫数据基于家长回忆，女性受试者明显较少，并且缺乏关于关键混杂因素的数据，如受试者使用大豆配方奶粉的原因、开始使用大豆配方奶粉的年龄以及使用大豆配方奶粉的时长。尽管有这些局限性，我们的结果表明，在自闭症儿童中，食用以大豆为基础的婴儿配方奶粉可能与两性的热性惊厥以及男性的癫痫诊断相关。鉴于缺乏关于关键混杂因素的数据以及该研究的回顾性性质，需要进行前瞻性研究来证实这种关联。
