Postgraduate Program in Nutrition, Federal University of Rio Grande do Norte-UFRN, Natal 59056-000, Brazil.
Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte-UFRN, Natal 59056-000, Brazil.
Nutrients. 2023 Aug 21;15(16):3663. doi: 10.3390/nu15163663.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, the prevalence of which has increased in children and adolescents over the years. Studies point to deficiency of trace elements as one of the factors involved in the etiology of the disorder, with zinc being one of the main trace elements investigated in individuals with ASD. The aim of this review is to summarize scientific evidence about the relationship between zinc status and ASD in children and adolescents. This review has been registered in the International Prospective Register of Systematic Reviews (registration number CRD42020157907). The methodological guidelines adopted were in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were selected from an active investigation of the PubMed, Scopus, LILACS, and Google databases to search for observational studies. Fifty-two studies from twenty-two countries were included. The sample sizes ranged from 20 to 2635, and the participants ranged from 2 to 18 years old. Nine types of biological matrices were used, with hair, serum, and plasma being the most frequently used in the evaluation of zinc concentrations. Significant differences in zinc concentrations between the ASD and control groups were observed in 23 studies, of which 19 (36%) showed lower zinc concentrations in the ASD group. The classification of studies according to methodological quality resulted in high, moderate, and low quality in 10, 21, and 21 studies, respectively. In general, we did not observe a significant difference between zinc concentrations of children and adolescents with ASD compared to controls; however, studies point to an occurrence of lower concentrations of Zn in individuals with ASD. This review reveals that more prospective studies with greater methodological rigor should be conducted in order to further characterize this relation.
自闭症谱系障碍（ASD）是一种神经发育障碍，近年来儿童和青少年的患病率有所增加。研究指出，微量元素缺乏是该疾病病因之一，锌是 ASD 患者中研究最多的微量元素之一。本综述旨在总结关于儿童和青少年锌状况与 ASD 之间关系的科学证据。本综述已在国际前瞻性系统评价登记处（注册号 CRD42020157907）进行了登记。采用的方法学指南符合系统评价和荟萃分析的首选报告项目（PRISMA）声明。从 PubMed、Scopus、LILACS 和 Google 数据库的主动调查中选择研究，以搜索观察性研究。从二十个国家纳入了五十二项研究。样本量从 20 到 2635 不等，参与者年龄从 2 到 18 岁不等。使用了九种生物基质，其中头发、血清和血浆在评估锌浓度中最常用。在 23 项研究中观察到 ASD 组和对照组之间锌浓度存在显著差异，其中 19 项研究（36%）显示 ASD 组的锌浓度较低。根据方法学质量对研究进行分类，分别有 10、21 和 21 项研究具有高、中、低质量。总体而言，我们没有观察到 ASD 儿童和青少年的锌浓度与对照组之间存在显著差异；然而，研究表明 ASD 个体中 Zn 浓度较低。本综述表明，应进行更多具有更高方法学严谨性的前瞻性研究，以进一步描述这种关系。
