叶酸和维生素B12与孤独症谱系障碍儿童症状和发育水平相关性研究

Relationship of folate and vitamin B12 with symptoms and mental development of children with autism spectrum disorder

目的探讨孤独症谱系障碍(ASD)儿童与正常儿童之间叶酸及维生素B12(VB12)水平的差异,并分析叶酸和VB12水平与ASD儿童症状及发育水平的相关性。方法对2016—2017年海南省妇幼保健院康复中心的244例ASD儿童采用孤独症行为量表(ABC)、社交反应量表(SRS)评估ASD儿童的症状,采用Gesell发育量表(GDS)评估ASD儿童的发育水平,同期选取93名海口市幼儿园的健康儿童作为对照组,采用免疫测定法检测两组儿童血清叶酸、VB12水平。结果 244例ASD儿童血清叶酸水平(10.68±4.08)明显低于93名正常儿童(11.83±4.37)(P=0.02),VB12浓度在两组之间差异无统计学意义(P>0.05)。叶酸和VB12浓度与ABC、SRS量表无相关关系。叶酸水平与GDS中的适应性行为(r_(s)=0.17,P=0.01)、大运动(r_(s)=0.29,P<0.01)、精细动作(r_(s)=0.13,P=0.04)、语言(r_(s)=0.13,P=0.04)以及个人-社会行为(r_(s)=0.14,P=0.03)均有明显正相关关系。VB12与GDS各能区无相关关系。结论 ASD儿童较正常儿童叶酸水平更低。叶酸水平与ASD儿童症状量表无明显相关性,与其发育水平具有明显正相关关系,叶酸可能与神经心理发育水平关系密切,其补充可能成为ASD儿童的辅助治疗手段之一。

Objective To explore differences in the level of folate and vitamin B12(VB12)of children with autism spectrum disorder(ASD)and normal children,and to investigate correlation of folate and VB12 level with symptoms and mental development of autistic children.Methods A total of 244 ASD children visiting Rehabilitation center of Hainan Maternal and Health Care Hospital from 2016 to 2017 were included in the study.The Autism Behavior Checklist(ABC)and Social Responsiveness Scale(SRS)were used to evaluate symptoms of children with ASD,and Gesell Developmental Scale(GDS)was used to evaluate mental development of children with ASD.A total of 93 healthy children from Haikou Kindergarten were selected in the same period as the control group.Folate and vitamin B12(VB12)levels were measured with immunoassay methods in two groups.Results The folate level of 244 children with ASD(10.68±4.08)was significantly lower than that of 93 normal children(11.83±4.37)(P=0.02).No significant difference regarding VB12 level was found between two groups(P>0.05).No correlation was found between folate,VB12 levels and ABC,SRS scales.Folate level was positively correlated with adaptive behavior(r_(s)=0.17,P=0.01),gross motor(r_(s)=0.29,P<0.01),fine motor(r_(s)=0.13,P=0.04),language(r_(s)=0.13,P=0.04),and per_(s)onal-social behavior(r_(s)=0.14,P=0.03)of GDS.There was no correlation between VB12 and GDS.Conclusion The children with autism have lower folate level than normal children,and folate level has no correlation with ASD.Folate level has significant correlation with mental development of autistic children.Folate may have close relationship with neuropsychological development.Therefore,folate supplement could become one of assistant methods in treatment of autistic children.