Principi Nicola, Esposito Susanna
Università degli Studi di Milano, Milan, Italy.
Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Front Psychiatry. 2020 Jan 31;10:987. doi: 10.3389/fpsyt.2019.00987. eCollection 2019.
Autism spectrum disorder is a neurodevelopmental disorder characterized by reduced social interactions, impaired communications, and stereotypic and repetitive behavior with different degrees of severity. The etiology of autism spectrum disorder is unknown, although the interaction of genetic and environmental factors is believed to play a fundamental role in the process. The main aim of this narrative review is to discuss the current knowledge about the interrelationships between vitamin D deficiency during pregnancy and autism spectrum disorder development. Literature analysis showed that vitamin D supplementation during pregnancy plays a role in conditioning the development and function of the nervous system. Studies carried out and in experimental animals have shown that vitamin D deficiency can be associated with structural and functional abnormalities of the nervous system that can be observed in autism spectrum disorder patients. Moreover, it has been reported that vitamin D deficiency during pregnancy could be a risk factor for autism spectrum disorder development in the offspring, that children with autism spectrum disorder have significantly lower serum levels of vitamin D than normal children and that supplementation of vitamin D in autism spectrum disorder children is associated with a reduction in psychiatric manifestations. However, the data currently available do not adequately support the hypothesis that vitamin D may be a factor which contribute to the etiology of autism spectrum disorder. The effects of vitamin D supplementation during pregnancy should be better studied to establish whether and when fetal vulnerability is highest and if vitamin D supplementation is able to reduce the risk of structural and functional alterations of the nervous system and autism spectrum disorder development. The role of vitamin D after birth must be better defined to evaluate if vitamin D administration is potentially effective in reducing autism spectrum disorder manifestations.
自闭症谱系障碍是一种神经发育障碍,其特征是社交互动减少、沟通障碍以及不同程度的刻板和重复行为。尽管认为遗传和环境因素的相互作用在自闭症谱系障碍的发病过程中起根本作用,但其病因尚不清楚。本叙述性综述的主要目的是讨论关于孕期维生素D缺乏与自闭症谱系障碍发生之间相互关系的现有知识。文献分析表明,孕期补充维生素D对神经系统的发育和功能具有调节作用。在人类和实验动物中开展的研究表明,维生素D缺乏可能与自闭症谱系障碍患者中可观察到的神经系统结构和功能异常有关。此外,有报道称孕期维生素D缺乏可能是后代患自闭症谱系障碍的一个危险因素,自闭症谱系障碍儿童的血清维生素D水平显著低于正常儿童,并且给自闭症谱系障碍儿童补充维生素D与精神症状的减轻有关。然而,目前可得的数据并不充分支持维生素D可能是导致自闭症谱系障碍病因的一个因素这一假说。应更好地研究孕期补充维生素D的效果,以确定胎儿易感性是否以及何时最高,以及补充维生素D是否能够降低神经系统结构和功能改变以及自闭症谱系障碍发生的风险。必须更好地明确出生后维生素D的作用,以评估给予维生素D是否可能有效减轻自闭症谱系障碍的症状。