重庆市某特教机构3～7岁孤独症谱系障碍儿童营养情况调查

Nutritional status in children aged 3 to 7 years with autism spectrum disorder at a special education institution in Chongqing City

目的比较3~7岁孤独症谱系障碍(autism spectrum disorder,ASD)儿童与正常儿童营养状况,为后期营养干预提供科学依据。方法采用随机整群抽样,对符合纳入标准的48名ASD儿童和42名正常儿童进行体格测量、食物称重法结合膳食回顾法的膳食调查、血常规和血清维生素A检测。结果 ASD儿童与正常儿童身高的Z值未见明显差异( P =0.611),ASD组体质量与体质指数的Z值更低( P =0.032、0.035);膳食调查显示,ASD儿童平均每日摄入的能量和3大营养素低于正常儿童( P <0.001),两组儿童每日摄入的膳食纤维、维生素A、维生素D、维生素B1、维生素B2、维生素B6、叶酸、钙存在不同程度的摄入不足;ASD组儿童每日摄入的维生素B1、维生素B2、钙的摄入不足率较对照组更高( P <0.001, P =0.001, P <0.001);两组儿童未见明显贫血与缺铁现象[贫血率比较 P =0.946,两组平均红细胞容积(MCV)、平均红细胞血红蛋白水平(MCH)、红细胞分布宽度(RDW)降低率比较 P =0.535、1.000、 0.946 ];ASD组儿童血清维生素A水平比正常儿童缺乏更为严重,且具有统计学差异( P =0.007)。结论 ASD儿童存在更为明显的营养素缺乏,提示临床医师需对ASD儿童进行膳食干预,进行个体化营养指导。

Objective To analyze and compare the nutritional status of children with autism spectrum disorders and typically developing children aged 3 to 7 years old at a special education institution in Chongqing so as to provide scientific basis for nutritional intervention. Methods This study recruited 48 autistic children and 42 typically developing children. We made anthropometric measurement,dietary assessment and biochemical assessment. Results WAZ and BAZ were found to be significantly lower in the children with ASD than those in typically developing children ( P =0.032,0.035). According to the dietary survey,the average daily intake of energy and three major nutrients were lower in the ASD group than in typically developing children ( P <0.001). Both groups did not meet the national recommendations for daily intake of fiber,vitamin A,vitamin D,vitamin B1,vitamin B2,vitamin B6,folic acid,and calcium. The intake insufficiency of vitamin B1,vitamin B2 and calcium was significantly lower in the autistic children than that in typically developing children ( P <0.001, P = 0.001 ,and P <0.001). In addition,anemia and iron deficiency was not found in the two groups (anemia P = 0.946;the reduction rate for MCV,MCH,and RDW P =0.535,1.000,and 0.946). However,we found a significantly lower level of serum vitamin A in the autistic children ( P =0.007). Conclusion Children with ASD had more obvious nutrient deficiency. It suggests that clinicians need to carry out dietary intervention and individualized nutrition guidance for children with ASD.