Zhao Hong-xiang, Yin Sha-sha, Fan Jin-gang
Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, Shandong, PR China.
Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, Shandong, PR China.
Int J Dev Neurosci. 2015 Apr;41:92-7. doi: 10.1016/j.ijdevneu.2015.02.002. Epub 2015 Feb 7.
Neopterin, a pteridine mainly synthesized by activated macrophages, is a marker of inflammation, immune system activation and an active participant in Autism spectrum disorders (ASD). The aim of this study was to assess the clinical significance of plasma neopterin levels in ASD.
Eighty patients diagnosed with ASD and 80 sex and age matched typically developing children were assessed for plasma levels of neopterin at admission. Plasma neopterin levels were measured using a human ELISA kit and severity of ASD were evaluated with the Childhood Autism Rating Scale (CARS) score.
We found that the mean plasma neopterin level was significantly (P<0.0001) higher in children with ASD as compared to controls. Plasma neopterin increased with increasing severity of ASD as defined by the CARS score. Based on the ROC curve, the optimal cutoff value of plasma neopterin level as an indicator for auxiliary diagnosis of ASD was projected to be 8.5nmol/L, which yielded a sensitivity of 84.2% and a specificity of 80.1%, with the area under the curve at 0.876 (95% CI, 0.825-0.928). Elevated neopterin (≥8.5nmol/L) was an independent diagnosis indicator of ASD with an adjusted OR of 12.11 (95% CI: 5.48-28.11; P<0.0001).
These results indicated that autistic children had higher plasma levels of neopterin, and elevated plasma neopterin levels may be associated with severity of ASD among Chinese children.
新蝶呤是一种主要由活化巨噬细胞合成的蝶啶,是炎症、免疫系统激活的标志物,也是自闭症谱系障碍(ASD)的积极参与者。本研究旨在评估血浆新蝶呤水平在ASD中的临床意义。
对80例诊断为ASD的患者和80例年龄和性别匹配的发育正常儿童在入院时评估血浆新蝶呤水平。使用人酶联免疫吸附测定(ELISA)试剂盒测量血浆新蝶呤水平,并用儿童自闭症评定量表(CARS)评分评估ASD的严重程度。
我们发现,与对照组相比,ASD儿童的平均血浆新蝶呤水平显著更高(P<0.0001)。血浆新蝶呤水平随着CARS评分所定义的ASD严重程度增加而升高。根据ROC曲线,血浆新蝶呤水平作为ASD辅助诊断指标的最佳截断值预计为8.5nmol/L,其灵敏度为84.2%,特异性为80.1%,曲线下面积为0.876(95%CI,0.825-0.928)。新蝶呤升高(≥8.5nmol/L)是ASD的独立诊断指标,校正后的比值比为12.11(95%CI:5.48-28.11;P<0.0001)。
这些结果表明,自闭症儿童的血浆新蝶呤水平较高,血浆新蝶呤水平升高可能与中国儿童ASD的严重程度有关。