Dong H Y, Wang B, Li H H, Shan L, Jia F Y
Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China.
Zhonghua Er Ke Za Zhi. 2017 Dec 2;55(12):916-919. doi: 10.3760/cma.j.issn.0578-1310.2017.12.010.
To explore the relationship between serum 25-hydroxyvitamin D levels and core symptoms of autism spectrum disorder (ASD) in children. In this cross-sectional study, ASD children 4 to 6 years of age who were diagnosed in Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin university from January to May 2017 were assigned to ASD group, and children for routine growth and development assessment in Jilin province were assigned to control group. The two groups were well matched for age and sex, and none of them had received vitamin D supplementation. Serum 25-hydroxyvitamin D levels were measured by HPLC-MS/MS method. The patients of the ASD group were assessed with autism behavior checklist (ABC), childhood autism rating scale (CARS), social response scale (SRS), and autism treatment evaluation checklist (ATEC). The levels of vitamin D were divided into normal(>0.03 ng/L), insufficient (0.01-0.03 ng/L) and deficient (<0.01 ng/L). Levels of serum vitamin D between the two groups were compared by two independent sample -test, and the difference in the percentages of normal, insufficient and deficient levels of vitamin D was tested by chi-square test, and correlations between vitamin D levels and the total scores or subscales of ABC, CARS, SRS and ATEC were analyzed by Pearson correlation analysis. The 87 subjects in the ASD group included 75 males and 12 females, with a mean (±SD) age of (4.7±0.7) years. The 301 subjects in the control group included 249 males and 52 females, with a mean (±SD) age of (4.8±0.8) years. Serum vitamin D level in ASD children was significantly lower than that of the control group ( (0.021±0.008) . (0.036±0.016) ng/L, -8.17, 0.01), and the between-group percentage difference of normal, insufficient and deficient levels of vitamin D was statistically significant (12 (14%) . 186 (62%) , 67 (77%) . 113 (37%) , 8 (9%) . 2 (1%) , χ(2)=72.1, 0.01). There were negative correlations between serum vitamin D level in ASD children and total ABC score or ABC subscale scores (body behavior, self-care, language and social interaction)(0.531,0.397,-0.283,-0.248,-0.262, 0.000, 0.000, 0.007, 0.020, 0.014). There were negative correlations between serum vitamin D level in ASD children and total CARS score and CARS subscale scores (imitation, nonverbal communication and general impression) (0.352, 0.216, 0.248, 0.216, 0.001, 0.046, 0.021, 0.046). There were negative correlations between serum vitamin D level in ASD children and SRS behavior subscale or ATEC social interaction subscale (0.536, 0.005, 0.400, 0.014). Serum 25-hydroxyvitamin D level in children with ASD is obviously lower than that in the healthy control group, and there are negative correlations between vitamin D levels and core symptoms of ASD. Trial registration Chinese Clinical Trial Registry, ChiCTR-CCC-13004498.
探讨儿童血清25-羟维生素D水平与自闭症谱系障碍（ASD）核心症状之间的关系。在这项横断面研究中，将2017年1月至5月在吉林大学第一医院发育与行为儿科确诊的4至6岁ASD儿童纳入ASD组，将吉林省进行常规生长发育评估的儿童纳入对照组。两组在年龄和性别上匹配良好，且均未接受过维生素D补充。采用HPLC-MS/MS法测定血清25-羟维生素D水平。ASD组患者采用自闭症行为量表（ABC）、儿童自闭症评定量表（CARS）、社会反应量表（SRS）和自闭症治疗评估量表（ATEC）进行评估。维生素D水平分为正常（>0.03 ng/L）、不足（0.01 - 0.03 ng/L）和缺乏（<0.01 ng/L）。两组间血清维生素D水平采用两独立样本t检验进行比较，维生素D正常、不足和缺乏水平的百分比差异采用卡方检验，维生素D水平与ABC、CARS、SRS和ATEC总分或子量表之间的相关性采用Pearson相关分析。ASD组87例受试者中，男性75例，女性12例，平均（±标准差）年龄为（4.7±0.7）岁。对照组301例受试者中，男性249例，女性52例，平均（±标准差）年龄为（4.8±0.8）岁。ASD儿童血清维生素D水平显著低于对照组（（0.021±0.008）.（0.036±0.016）ng/L，-8.17，P = 0.01），两组间维生素D正常、不足和缺乏水平的百分比差异有统计学意义（分别为12（14%）.186（62%），67（77%）.113（37%），8（9%）.2（1%），χ² = 72.1，P < 0.01）。ASD儿童血清维生素D水平与ABC总分或ABC子量表得分（身体行为、自我照顾、语言和社会交往）之间存在负相关（r = 0.531，0.397，-0.283，-0.248，-0.262，P = 0.000，0.000，0.007，0.020，0.014）。ASD儿童血清维生素D水平与CARS总分及CARS子量表得分（模仿、非言语交流和总体印象）之间存在负相关（r = 0.352，0.216，0.248，0.216，P = 0.001，0.046，0.021，0.046）。ASD儿童血清维生素D水平与SRS行为子量表或ATEC社会交往子量表之间存在负相关（r = 0.536，0.005，0.400，0.014）。ASD儿童血清25-羟维生素D水平明显低于健康对照组，且维生素D水平与ASD核心症状之间存在负相关。试验注册号：中国临床试验注册中心，ChiCTR-CCC-13004498 。
