Department of Anatomy, Neuroscience Research Center, Hebei Medical University, Shijiazhuang, China.
Hebei Key Laboratory of Neurodegenerative Disease Mechanism, Shijiazhuang, China.
Front Endocrinol (Lausanne). 2024 May 8;15:1371148. doi: 10.3389/fendo.2024.1371148. eCollection 2024.
Accumulating evidence suggests that the autism spectrum disorder (ASD) population exhibits altered hormone levels, including androgens. However, studies on the regulation of androgens, such as testosterone and dehydroepiandrosterone (DHEA), in relation to sex differences in individuals with ASD are limited and inconsistent. We conducted the systematic review with meta-analysis to quantitatively summarise the blood, urine, or saliva androgen data between individuals with ASD and controls.
A systematic search was conducted for eligible studies published before 16 January 2023 in six international and two Chinese databases. We computed summary statistics with a random-effects model. Publication bias was assessed using funnel plots and heterogeneity using I statistics. Subgroup analysis was performed by age, sex, sample source, and measurement method to explain the heterogeneity.
17 case-control studies (individuals with ASD, 825; controls, 669) were assessed. Androgen levels were significantly higher in individuals with ASD than that in controls (SMD: 0.27, 95% CI: 0.06-0.48, =0.01). Subgroup analysis showed significantly elevated levels of urinary total testosterone, urinary DHEA, and free testosterone in individuals with ASD. DHEA level was also significantly elevated in males with ASD.
Androgen levels, especially free testosterone, may be elevated in individuals with ASD and DHEA levels may be specifically elevated in males.
越来越多的证据表明，自闭症谱系障碍（ASD）患者的激素水平发生改变，包括雄激素。然而，关于雄激素（如睾酮和脱氢表雄酮（DHEA））与 ASD 患者性别差异之间的关系的研究有限且结果不一致。我们进行了系统评价和荟萃分析，以定量总结 ASD 患者和对照组之间的血液、尿液或唾液雄激素数据。
在六个国际数据库和两个中文数据库中，对截至 2023 年 1 月 16 日发表的合格研究进行了系统搜索。我们使用随机效应模型计算汇总统计数据。使用漏斗图和 I ² 统计量评估发表偏倚和异质性。通过年龄、性别、样本来源和测量方法进行亚组分析，以解释异质性。
评估了 17 项病例对照研究（ASD 患者 825 例，对照组 669 例）。ASD 患者的雄激素水平明显高于对照组（SMD：0.27，95%CI：0.06-0.48，=0.01）。亚组分析显示，ASD 患者的尿总睾酮、尿 DHEA 和游离睾酮水平显著升高。DHEA 水平在 ASD 男性中也显著升高。
ASD 患者的雄激素水平，尤其是游离睾酮水平可能升高，而 DHEA 水平在男性中可能特异性升高。
