Wang Lixuan, Jia Jianpu, Zhang Junling, Li Kuo
No. 2 Department of Neurology, Cangzhou Central Hospital, Cangzhou 061001, China.
No. 2 Department of Neurology, Cangzhou Central Hospital, Cangzhou 061001, China.
Int J Dev Neurosci. 2016 Jun;51:12-6. doi: 10.1016/j.ijdevneu.2016.04.004. Epub 2016 Apr 16.
Autism is a severe developmental disorder with poorly understood etiology. This study examined the clinical significance of serum superoxide dismutase (SOD) level, a marker of oxidative stress, in children with autism spectrum disorder (ASD) and typically-developing children between the ages of 2 and 6 years.
Ninety-six children diagnosed with ASD and 96 sex and age matched typically-developing children were assessed for serum levels of SOD at admission. S0D were assayed by colorimetry, and severity of ASD was evaluated with the Childhood Autism Rating Scale (CARS) Score. The influence of serum SOD levels on ASD was performed by conditional logistic regression analysis, which allows adjustment for confounding factors.
The median serum SOD levels were significantly (P<0.001) lower in children with ASD as compared to typically-developing children [146 (IQR: 133-165) U/ml and 180 (168-199) U/ml, respectively]. Levels of SOD increased with decreasing severity of ASD as defined by the CARS score (r=-0.432, P<0.0001). After adjusting for all other possible covariates, SOD remained can be seen as an independent indictor of ASD with an adjusted odds ratio (OR) of 0.955 (95% confidence interval [CI], 0.942-0.969; P<0.001). Based on the receiver operating characteristic (ROC) curve, the optimal cutoff value of serum level of SOD as an indicator for auxiliary diagnosis of ASD was projected to be 160U/ml, which yielded a sensitivity of 84.7% and a specificity of 71.4%, with the area under the curve at 0.811 (95%CI, 0.747-0.874).
Our data suggests that the decreased serum SOD levels could be implicated in the pathophysiology and progression of autism in Chinese children and can be used as an independent risk indicator of ASD.
自闭症是一种病因尚不明确的严重发育障碍。本研究探讨了氧化应激标志物血清超氧化物歧化酶(SOD)水平在2至6岁自闭症谱系障碍(ASD)儿童和发育正常儿童中的临床意义。
对96名被诊断为ASD的儿童和96名性别及年龄匹配的发育正常儿童入院时的血清SOD水平进行评估。采用比色法测定SOD,并用儿童自闭症评定量表(CARS)评分评估ASD的严重程度。通过条件逻辑回归分析血清SOD水平对ASD的影响,该分析可对混杂因素进行校正。
与发育正常儿童相比,ASD儿童的血清SOD水平中位数显著降低(P<0.001)[分别为146(四分位数间距:133 - 165)U/ml和180(168 - 199)U/ml]。根据CARS评分定义,SOD水平随ASD严重程度降低而升高(r = -0.432,P<0.0001)。在对所有其他可能的协变量进行校正后,SOD仍可被视为ASD的独立指标,校正比值比(OR)为0.955(95%置信区间[CI],0.942 - 0.969;P<0.001)。根据受试者工作特征(ROC)曲线,血清SOD水平作为ASD辅助诊断指标的最佳截断值预计为160U/ml,其灵敏度为84.7%,特异度为71.4%,曲线下面积为0.811(95%CI,0.747 - 0.874)。
我们的数据表明,血清SOD水平降低可能与中国儿童自闭症的病理生理过程和进展有关,可作为ASD的独立风险指标。