孤独症谱系障碍儿童血清多不饱和脂肪酸水平的研究

Serum polyunsaturated fatty acid levels in children with autism spectrum disorders

目的研究孤独症谱系障碍(ASD)儿童血清多不饱和脂肪酸(PUFAs)的表达水平,为ASD的诊治提供理论依据。方法2020年12月—2021年6月在上海市儿童医院儿童保健科选取45例ASD儿童及30例对照组儿童为研究对象,通过液相-串联质谱法对其外周血血清进行PUFAs含量测定;通过简易孤独症饮食行为量表(BAMBI)及自制膳食调查问卷了解ASD儿童与对照组饮食行为习惯及饮食结构上的差异,进一步分析ASD儿童血清PUFAs表达水平的影响因素。结果ASD组儿童血清中二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)、花生四烯酸(AA)、亚油酸(LA)、总n-3 PUFAs及总n-6 PUFAs下降(t=2.81、2.04、2.94、2.33、2.11、2.63,P<0.05),其中EPA及AA下降明显(P<0.01)。ASD组儿童在拒食行为、与ASD特征相关喂养问题、食物谱狭窄及总分方面均高于对照组儿童(t=2.93、13.42、2.22、8.40,P<0.05),ASD组儿童对饮食的总体兴趣低于对照组(t=2.70,P<0.05),尤其对鱼类的兴趣偏低(t=5.03,P<0.05)。结论ASD儿童血清多数PUFAs含量比正常儿童低,可能与饮食行为及饮食偏好有关,补充PUFAs可能成为ASD儿童的辅助治疗手段之一。

Objective To investigate the expression level of serum polyunsaturated fatty acids(PUFAs) in children with autism spectrum disorder(ASD), in order to provide theoretical basis for the diagnosis and treatment of ASD. Methods From December 2020 to June 2021, 45 ASD children and 30 typically developed children were selected in the Department of Children Health Care of Shanghai Children′s Hospital. The content of PUFAs in their peripheral blood serum was determined by liquid chromatography-tandem mass spectrometry. The Brief Autism Mealtime Behavior Inventory(BAMBI) and a self-designed dietary questionnaire were used to understand the differences in dietary behavior and dietary structure between ASD children and the control group. Then the influencing factors of serum PUFAs expression level in ASD children were further analyzed. Results Serum levels of eicosapentaenoic acid(EPA), docosahexaenoic acid(DHA), arachidonic acid(AA), linoleic acid(LA), total n-3 PUFAs and total n-6 PUFAs in ASD group were decreased(t=2.81,2.04,2.94,2.33,2.11,2.63, P<0.05), especially EPA and AA were significantly decreased(P<0.01). Diet and behavioral problems(including food refusal, ASD related feeding problems, limited variety of foods) and total score of children in the ASD group were higher than those in the control group(t=2.93, 13.42, 2.22, 8.40, P<0.05). The overall interest in diet of children in ASD group was lower than that in the control group(t=2.70, P<0.05), especially in fish(t=5.03, P<0.05). Conclusions The content of serum PUFAs in ASD children is lower than that in healthy children, which may be related to dietary behavior and dietary preference. Supplement of PUFAs may be one of the auxiliary methods for the treatment of ASD children.