Objective To investigate the characteristics of 25 (0H) D level in children with ASD and its correlation with clinical features.
Methods A total of 196 children with ASD who received outpatient and inpatient rehabilitation training from January 2017 to January 2019 were included in ASD group, and 178 healthy children who visited the hospital during the same period were included in healthy control group. Differences in 25 (0H) D levels and general data between study group and healthy control group were compared. In addition, ASD group was divided into 25 (0H) D normal group and abnormal group in accordance with 25 (0H) D level (≥30 ng/mL). Differences in general data, total score of CARS scale and factor scores were compared between two groups. Finally, the correlation between serum 25 (0H) D level and CARS total score and factor scores of children with ASD was evaluated.
Results 25 (0H) D level in ASD group was significantly lower than that in healthy control group ( P<0.01). The incidence of sleep disorder, dietary bias, vomiting, constipation and diarrhea in children with ASD was statistically significant compared with that of healthy children ( P<0.01); there were statistically significant differences in breastfeeding, sleep disorder, dietary bias and diarrhea between 25 (0H) D normal group and abnormal group (χ 2 =4.97, 8.69, 6.67, 3.98, P<0.05); there were statistically significant differences in 10 aspects including CARS total score, interpersonal relationship, imitation, emotional response, physical use ability, relationship with inanimate objects, adaptation to environmental changes, visual response, auditory response and general impression ( P<0.05); there was a significant negative correlation between serum 25 (0H) D level and CARS total score in children with ASD ( r = -0.32, P<0.01).
Conclusion Breastfeeding could reduce the risk of 25 (0H) D abnormalities in children with ASD. 25 (0H) D reduction would cause sleep disorder, dietary bias and gastrointestinal problems, while dietary bias and gastrointestinal problems would affect 25 (0H) D uptake and absorption. 25 (0H) D might be related to the occurrence of ASD in children. Serum 25 (0H) D level could be used as a reference index for the severity of ASD in children.
【摘要】 目的 研究孤独症谱系障碍(ASD)患儿25羟维生素D水平[25(OH) D]特点及其与临床特征的相关性, 为 孤独症谱系障碍的病因研究提供数据支撑。 方法 收集2017年1月至2019年1月期间武汉市优抚医院门诊及住院康复 训练的ASD患儿196例为ASD组, 同时收集同期来院就诊的健康儿童178例为健康对照组, 比较两组25(0H)D水平及一 般资料的差异。根据25(0H)D水平(≥30 ng/mL)将ASD组分为25(0H)D正常组与异常组, 比较两组一般资料、儿童孤 独症评定量表(CARS)总分及各因子分的差异, 评估ASD患儿血清25(0H)D水平与CARS总分及各因子分的相关性。 结果 ASD组25(0H)D水平低于健康对照组( P<0.01), ASD患儿中睡眠障碍、偏食、呕吐、便秘、腹泻的报告率与健康儿童 相比差异有统计学意义( P值均<0.01);25(0H)D正常组与异常组在母乳喂养、睡眠障碍、偏食、腹泻报告率差异有统计学 意义(χ 2值分别为4.97, 8.69, 6.67, 3.98, P值均<0.05), 在CARS总分、人际关系、模仿、情感反应、躯体运用能力、与非生命 物体的关系、对环境变化的适应、视觉反应、听觉反应、一般印象10个方面差异均有统计学意义( P值均<0.05);人30患儿 血清25(0H)D水平与CARS总分呈负相关( r =-0.32, P<0.01)。 结论 母乳喂养可降低ASD患儿25(0H)D水平异常的 风险, 25(0印0水平降低会引起睡眠障碍、偏食以及胃肠道问题, 而偏食及胃肠道问题也会影响25(0H)D的摄取和吸 收。25(0H)D与儿童ASD的发生可能有一定的关系, 可将血清25(0H)D水平作为ASD患儿病情严重程度的参考指标。