孤独症患儿血清25(OH)D、叶酸水平及临床意义

The levels of serum 25(OH)D,folic acid and their clinical significance in children with autism spectrum disorder

目的探讨孤独症谱系障碍(ASD)患儿血清25羟维生素D[25(OH)D]、叶酸水平及其临床意义。方法纳入2018年2月~2020年2月我院200例ASD患儿,设为ASD组,并按病情分为轻中度(132例)与重度组(68例),选择年龄、性别配对的同期入院体检的200例正常儿童为对照组,比较他们的血清25(OH)D、叶酸及叶酸代谢产物叶酸受体自身抗体(FRAA)以及5-甲基四氢叶酸(5-MTHF)水平。结果ASD组血清25(OH)D、叶酸、5-MTHF水平显著低于对照组,FRAA水平、儿童孤独症评定量表(CARS)显著高于对照组(P<0.05);重度组血清25(OH)D、叶酸、5-MTHF水平显著低于轻中度组,FRAA水平、CARS评分显著高于轻中度组(P<0.05);血清25(OH)D、叶酸、5-MTHF水平与CARS评分呈负相关,FRAA水平与CARS评分呈正相关(P<0.05)。结论ASD的发病与病情进展可能与25(OH)D、叶酸缺乏以及代谢紊乱有关,可据此开展靶向营养或药物干预进行ASD的辅助治疗或预防。

Objective To explore the level of serum 25-hydroxyvitamin D[25(OH)D],folate levels and their clinical significance in children with autism spectrum disorder(ASD).Methods A total of 200 children with ASD in our hospital from February 2018 to February 2020 were selected as the ASD group,who were divided into light moderate group(n=132)and severe group(n=68)according to the condition.200 normal children who were admitted to the hospital during the same period were selected as the control group.Serum 25(OH)D,folate and folate metabolite folate receptor autoantibodies(FRAA)and 5-methyltetrahydrofolate(5-MTHF)were compared between the two groups.Results The levels of serum 25(OH)D,folic acid and 5-MTHF in the ASD group were significantly lower than those in the control group,and the FRAA levels and Child Autism Rating Scale(CARS)were significantly higher than those in the control group(P<0.05).The levels of serum 25(OH)D,folic acid and 5-MTHF in the severe group were significantly lower than those in the mild-moderate group,and the FRAA levels and CARS scores were significantly higher than those in the mild-moderate group(P<0.05).Serum 25(OH)D,folic acid and 5-MTHF levels were negatively correlated with CARS scores,and FRAA levels were positively correlated with CARS scores(P<0.05).Conclusion The onset and progression of ASD may be related to 25(OH)D,folic acid deficiency,and metabolic disorders,which can be used to carry out targeted nutrition or drug intervention for adjuvant treatment or prevention of ASD.