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自闭症谱系障碍中的维生素D状况及维生素D补充剂对自闭症儿童的疗效。

Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children.

作者信息

Saad Khaled, Abdel-Rahman Ahmed A, Elserogy Yasser M, Al-Atram Abdulrahman A, Cannell John J, Bjørklund Geir, Abdel-Reheim Mohamed K, Othman Hisham A K, El-Houfey Amira A, Abd El-Aziz Nafisa H R, Abd El-Baseer Khaled A, Ahmed Ahmed E, Ali Ahmed M

机构信息

a Department of Pediatrics, Faculty of Medicine , Assiut University , Egypt.

b Department of Neuropsychiatry, Faculty of Medicine , Assiut University , Egypt.

出版信息

Nutr Neurosci. 2016 Oct;19(8):346-351. doi: 10.1179/1476830515Y.0000000019. Epub 2015 Apr 15.

Abstract

OBJECTIVES

Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and non-verbal communication, and stereotyped patterns of interests and activities. Vitamin-D deficiency was previously reported in autistic children. However, the data on the relationship between vitamin D deficiency and the severity of autism are limited.

METHODS

We performed a case-controlled cross-sectional analysis conducted on 122 ASD children, to assess their vitamin D status compared to controls and the relationship between vitamin D deficiency and the severity of autism. We also conducted an open trial of vitamin D supplementation in ASD children.

RESULTS

Fifty-seven percent of the patients in the present study had vitamin D deficiency, and 30% had vitamin D insufficiency. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-OHD levels had significant negative correlations with Childhood Autism Rating Scale (CARS) scores. Of the ASD group, 106 patients with low-serum 25-OHD levels (<30 ng/ml) participated in the open label trial. They received vitamin D3 (300 IU/kg/day not to exceed 5000 IU/day) for 3 months. Eighty-three subjects completed 3 months of daily vitamin D treatment. Collectively, 80.72% (67/83) of subjects who received vitamin D3 treatment had significantly improved outcome, which was mainly in the sections of the CARS and aberrant behavior checklist subscales that measure behavior, stereotypy, eye contact, and attention span.

CONCLUSION

Vitamin D is inexpensive, readily available and safe. It may have beneficial effects in ASD subjects, especially when the final serum level is more than 40 ng/ml.

TRIAL REGISTRATION NUMBER

UMIN-CTR Study Design: trial Number: R000016846.

摘要

目的

自闭症谱系障碍(ASD)是一种发育障碍,其特征为社交互动普遍存在缺陷、言语和非言语沟通受损,以及兴趣和活动模式刻板。先前有报道称自闭症儿童存在维生素D缺乏。然而,关于维生素D缺乏与自闭症严重程度之间关系的数据有限。

方法

我们对122名自闭症谱系障碍儿童进行了病例对照横断面分析,以评估他们与对照组相比的维生素D状态,以及维生素D缺乏与自闭症严重程度之间的关系。我们还对自闭症谱系障碍儿童进行了维生素D补充的开放试验。

结果

本研究中57%的患者存在维生素D缺乏,30%存在维生素D不足。重度自闭症患者的平均25-羟基维生素D水平显著低于轻度/中度自闭症患者。血清25-羟基维生素D水平与儿童自闭症评定量表(CARS)评分呈显著负相关。在自闭症谱系障碍组中,106名血清25-羟基维生素D水平低(<30 ng/ml)的患者参与了开放标签试验。他们接受维生素D3(300 IU/kg/天,不超过5000 IU/天)治疗3个月。83名受试者完成了3个月的每日维生素D治疗。总体而言,接受维生素D3治疗的受试者中有80.72%(67/83)的结果有显著改善,主要体现在CARS和异常行为检查表子量表中测量行为、刻板动作、眼神接触和注意力广度的部分。

结论

维生素D价格低廉、易于获取且安全。它可能对自闭症谱系障碍患者有有益影响,尤其是当最终血清水平超过40 ng/ml时。

试验注册号

UMIN-CTR研究设计:试验编号:R000016846

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