Azouz Hanan Galal, Zakaria Nermine Hossam El-Din, Khalil Ahmed Fouad, Naguib Sara Mohammad, Khalil Mona
Department of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Clinical and chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Prz Gastroenterol. 2021;16(4):352-357. doi: 10.5114/pg.2021.111420. Epub 2021 Dec 2.
A common comorbidity in autism spectrum disorder (ASD) children is gastrointestinal problems, and a possible link between active gastrointestinal inflammation and autism has been suggested. Faecal calprotectin (FC) is a non-invasive marker for of gastrointestinal inflammation.
To study the level of FC as a marker of bowel inflammation in children with ASD and its possible relation to gastrointestinal manifestations.
Calprotectin levels were assessed in stool samples of 40 ASD children. Autism severity was assessed by the Childhood Autism Rating Scale (CARS). Severity of gastrointestinal symptoms was assessed using a modified version of the 6-Item Gastrointestinal Severity Index (6-GSI) questionnaire. A control group of 40 healthy children matched for age and sex with the cases was also included to compare their levels of FC.
Gastrointestinal symptoms were present in 82.5% of children with autism; the most reported offensive stool odour (70%) and the least diarrhoea (17.5%), and a high 6-GSI score was observed in 35% of ASD children. FC levels were elevated in 35% of the cases and in 25% of the control group. The mean levels of FC of cases were significantly elevated compared to levels of controls. FC levels positively correlated with severity of gastrointestinal symptoms (6-GSI) in autistic patients. There was positive correlation between CARS and 6-GSI.
Gastrointestinal manifestations are a common comorbidity in autistic patients. ASD patients have significantly higher FC levels than healthy controls. FC levels are strongly correlated with the severity of gastrointestinal manifestations in ASD children. So, gastrointestinal manifestations among autistic patients could be caused by gastrointestinal inflammation.
自闭症谱系障碍（ASD）儿童常见的合并症是胃肠道问题，并且有人提出胃肠道活动性炎症与自闭症之间可能存在联系。粪便钙卫蛋白（FC）是胃肠道炎症的一种非侵入性标志物。
研究FC水平作为ASD儿童肠道炎症标志物及其与胃肠道表现的可能关系。
对40名ASD儿童的粪便样本进行钙卫蛋白水平评估。采用儿童自闭症评定量表（CARS）评估自闭症严重程度。使用改良版的6项胃肠道严重程度指数（6-GSI）问卷评估胃肠道症状的严重程度。还纳入了40名年龄和性别与病例匹配的健康儿童作为对照组，以比较他们的FC水平。
82.5%的自闭症儿童存在胃肠道症状；最常报告的是大便异味（70%），腹泻最少（17.5%），35%的ASD儿童6-GSI评分较高。35%的病例和25%的对照组FC水平升高。病例组的FC平均水平与对照组相比显著升高。自闭症患者中FC水平与胃肠道症状严重程度（6-GSI）呈正相关。CARS与6-GSI之间存在正相关。
胃肠道表现是自闭症患者常见的合并症。ASD患者的FC水平显著高于健康对照组。FC水平与ASD儿童胃肠道表现的严重程度密切相关。因此，自闭症患者的胃肠道表现可能由胃肠道炎症引起。
