Department of Children's Nutrition Research Center; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, China.
Eur J Clin Nutr. 2021 Jul;75(7):1118-1125. doi: 10.1038/s41430-020-00827-9. Epub 2020 Dec 16.
Children in China with Autism Spectrum Disorders (ASD) are prone to vitamin A deficiency (VAD). The present study compared two vitamin A supplements (VAS) in two groups of children with ASD and VAD to explore a better VAS program for children with ASD.
A total of 138 3-8-year-old children with ASD (118 males and 20 females) were enrolled in this 6-month study. Of these 138 children, 82 who had VAD (ASD-VAD) were divided into two VAS groups that received the recommended VAS program (RNI-VAS) or a weekly dose of VAS (WD-VAS). The 56 children who had normal vitamin A levels (ASD-VAN) served as a control group. The Social Responsiveness Scale (SRS) was used to assess the severity of social impairment before and after the interventions. Their serum retinol (VA) and oxytocin (OXT) concentrations, the mRNA expression of retinoic acid receptors (RARs), and CD38 gene in peripheral blood was measured before and after the 6-month intervention.
The WD-VAS program increased VA levels better than the RNI-VAS program did (P < 0.01), and it significantly decreased SRS scores (P < 0.05). In addition, the change in VA was positively correlated with the change in mRNA levels in RARβ (r = 0.2441, P = 0.0092), the CD38 in PBMC (r = 0.2729, P = 0.0033), and the change in OXT concentration in serum (r = 0.3735, P < 0.0001). VA was also negatively correlated with changes in SRS scores across the three groups (r = -0.2615, P = 0.0026).
The WD-VAS might be more suitable for children with ASD and VAD than other interventions to improve both VA and social functioning, which may be mediated through the RARβ-CD38-OXT axis.
中国自闭症谱系障碍（ASD）儿童易患维生素 A 缺乏症（VAD）。本研究比较了 ASD 合并 VAD 儿童两组维生素 A 补充剂（VAS），以探索更适合 ASD 儿童的 VAS 方案。
本研究纳入了 138 名 3-8 岁 ASD 儿童（男 118 名，女 20 名），进行了为期 6 个月的研究。其中 82 名 VAD 儿童（ASD-VAD）分为两组，分别接受推荐维生素 A 摄入量（RNI-VAS）或每周剂量维生素 A（WD-VAS）。56 名维生素 A 水平正常的儿童（ASD-VAN）作为对照组。干预前后采用社会反应量表（SRS）评估社会障碍严重程度。干预前后分别检测血清视黄醇（VA）和催产素（OXT）浓度、外周血维 A 酸受体（RARs）mRNA 表达及 CD38 基因。
WD-VAS 方案较 RNI-VAS 方案更能提高 VA 水平（P<0.01），且显著降低 SRS 评分（P<0.05）。此外，VA 变化与 RARβ（r=0.2441，P=0.0092）、PBMC 中 CD38（r=0.2729，P=0.0033）mRNA 水平和血清 OXT 浓度的变化呈正相关（r=0.3735，P<0.0001）。VA 与三组间 SRS 评分变化呈负相关（r=-0.2615，P=0.0026）。
WD-VAS 可能比其他干预措施更适合 ASD 合并 VAD 儿童，改善 VA 和社会功能，可能通过 RARβ-CD38-OXT 轴介导。
