Vasconcelos Cristiane, Perry Ingrid Schweigert, Gottfried Carmem, Riesgo Rudimar, Castro Kamila
Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Nutr Neurosci. 2025 Mar;28(3):273-307. doi: 10.1080/1028415X.2024.2367855. Epub 2024 Jul 5.
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that impairs communication, socialization, and behavior. The association of ASD with folic acid has been investigated due to the importance of this vitamin for neurological health. This study is an update of the publication 'Folic acid and autism: What do we know?' and aims to systematically review studies examining the relationship between folic acid and ASD. The search resulted in 2,389 studies on folic acid and ASD, which were selected by two reviewers based on their titles and abstracts. Studies meeting the inclusion criteria were fully read. The 52 included studies involved 10,429 individuals diagnosed with ASD and assessed the intake of vitamin B6, folic acid, and vitamin B12; serum levels of these vitamins, homocysteine, and methionine; therapeutic interventions using folic acid; and the association between maternal exposure to this vitamin and the risk of ASD. The evidence of insufficient folic acid intake in most individuals with ASD remains consistent in this update. No association was found between maternal exposure to folic acid and the risk of ASD in their children. Despite observed improvements in communication, socialization, and behavior in individuals with ASD following folic acid interventions, it is crucial to consider the individuality and complexity of ASD. Given the relevance of the topic, there remains a need for more high-quality research and clinical trials characterized by rigorous methodological designs.
自闭症谱系障碍（ASD）是一种复杂的神经发育疾病，会损害沟通、社交和行为能力。由于这种维生素对神经健康的重要性，人们对ASD与叶酸之间的关联进行了研究。本研究是对《叶酸与自闭症：我们知道什么？》这一出版物的更新，旨在系统回顾研究叶酸与ASD之间关系的各项研究。检索结果得到了2389项关于叶酸与ASD的研究，由两位评审员根据标题和摘要进行筛选。符合纳入标准的研究进行了全文阅读。纳入的52项研究涉及10429名被诊断为ASD的个体，评估了维生素B6、叶酸和维生素B12的摄入量；这些维生素、同型半胱氨酸和蛋氨酸的血清水平；使用叶酸的治疗干预措施；以及母亲接触这种维生素与ASD风险之间的关联。在本次更新中，大多数ASD个体叶酸摄入不足的证据仍然一致。未发现母亲接触叶酸与其子女患ASD风险之间存在关联。尽管观察到ASD个体在接受叶酸干预后沟通、社交和行为方面有所改善，但考虑到ASD的个体性和复杂性至关重要。鉴于该主题的相关性，仍然需要更多高质量的研究和具有严格方法设计的临床试验。
