Correlation Between Vitamin D And Autism Spectrum Disorder In Children

Part I Comparison of serum 25(OH)D levels between children with ASD aged 1 year to 6 years and healthy children in HainanObjective: To study the changes of serum 25(OH)D levels in children with ASD.Methods: Eighty-six children diagnosed with ASD in the Department of Neurological Rehabilitation,Hainan Women and Children’s Medical Center from January 2021 to December 2021 were collected as the ASD group,74 males and 12 females,aged 1 year to 6 years(2.83(2.25,3.58)years).Eighty-six healthy children who underwent routine physical examination in this hospital during the same period were matched as the control group.There were 74 males and 12 females,ranging from 1 year to 6 years(2.83(2.25,3.58)years).SPSS 25.0 was applied for statistical analysis.Results: 1.There were no significant differences in age,gender and season of blood collection between ASD control group(z=-0.02,P=0.99;χ2 = 0.00,P = 1.00;χ2= 0.00,P = 1.00).The 25(OH)D level was significantly lower in the ASD control group(94.41(82.83,113.39)nmol/L vs 106.95(85.20,122.00)nmol/L,z=-2.20,P=0.03).Compared with the ASD control group,the serum 25(OH)D levels were significantly decreased in male children(94.41(82.38,113.39)nmol/L vs 106.20(88.41,122.03)nmol/L,z=-2.45,P=0.01),children aged 1 year to 3 years(99.12(84.82,114.51)nmol/L vs 115.70(102.50,133.48)nmol/L,z=-3.57,P=0.00),children with blood collection time in winter and spring(91.62(82.83,103.84) nmol/L vs 110.80(82.81,122.25)nmol/L,z=-2.23,P=0.03),and the differences were statistically significant;while the serum 25(OH)D levels were significantly decreased in female children(95.04(83.15,118.00)nmol/L vs 108.80(74.43,115.80)nmol/L,z=-0.12,P=0.91),children older than 3 years(90.21(76.73,111.72)nmol/L vs 88.26(75.89,106.08)nmol/L,z=-0.41,P=0.68),and children with blood collection time in summer and autumn(97.86(81.80,119.07)nmol/L vs 104.30(86.34,120.33)nmol/L,z=-0.91,P=0.37)there were no significant differences in serum 25(OH)D.2.There was no significant difference in serum 25(OH)D levels between male ASD children and females(94.41(82.38,113.39)nmol/L 比 95.04(83.15,118.00)nmol/L,z=-0.29,P=0.77),serum 25(OH)D levels between ASD children aged 1 year to 3 years and those aged older than 3 years(95.04(83.15,118.00)nmol/L vs 90.21(76.73,112.72)nmol/L,z=1.3,P=0.19),serum 25(OH)D levels in ASD children with winter and spring blood sampling seasons compared with summer and autumn(91.62(82.83,103.84)nmol/L vs 97.86(81.80,119.70)nmol/L,z=-0.93,P=0.35),and serum 25(OH)D levels between mild moderate severe ASD children((99.23(77.54,119.73)nmol/L vs 95.55(86.45,112.21)nmol/L比 95.06(75.75,127.28)nmol/L,H=0.17,P=0.92).There was no correlation between 25(OH)D levels and the total Gesell Developmental Scale score,dimension scores: adaptive behavior,gross motor,fine motor,language,and personal-social behavior in the ASD group(r = 0.69,0.41,0.15,0.26,0.26,0.07;P = 0.55,0.72,0.19,0.82,0.82,0.53).Conclusion: Reduced serum 25(OH)D levels may be one of the risk factors for the pathogenesis of ASD.Part II A systematic review and meta-analysis of the efficacy of vitamin D in the treatment of children with ASDObjective: To systematically evaluate the efficacy of vitamin D treatment in children with ASD.Methods: CNKI,Wanfang,CBM,VIP,Chinese Clinical Trial Registry,Pub Med, Embase,Web of science,Clinical Trials and Cochrane library databases were searched by computer for randomized controlled trials of vitamin D in the treatment of ASD from database establishment to February 1,2022.After two investigators independently screened the literatures,extracted the data and evaluated the risk of bias of the included studies,Rev Man 5.4 and Stata 16.0 software were used for metaanalysis.Results: A total of 10 articles with a total of 891 children were included.Metaanalysis showed that serum 25(OH)D levels were significantly increased in ASD children after vitamin D supplementation compared with those before intervention [SMD = 0.83,95% CI:(0.56,1.09),P < 0.00001];however,there were no significant differences in scores in all energy areas of the Aberrant Behavior Checklist: except for irritability scores,which were significantly decreased [MD:-3.19,95% CI:(-5.54,-0.85),P = 0.008],other energy areas scores: lethargy/social withdrawal scores [MD =-1.31,95% CI:(-3.56,0.94),P = 0.25],inappropriate speech scores [MD: 0.09,95% CI:(-1.38,1.57),P = 0.90],adaptive behavior scores [MD: 0.79,95% CI:(-0.26,1.84),P = 0.14],and hyperactivity scores [MD:-2.49,95% CI:(-5.54,0.55),P = 0.11];there was no significant difference in the scores of the stereotyped subscale of the stereotypy subscale of the Gilliam Autism Rating Scale-Second Edition [MD:-0.70,95% CI:(-3.13,1.74),P = 0.57];there was also a significant difference in the total score of the Social Responsiveness Scale [MD =-6.68,95% CI:(-15.11,1.75),P = 0.12],and the total score of the Childhood Autism Rating Scale [MD=-6.68,95%CI :(-15.11,1.75),P=0.12],or the total Autism Treatment Evaluation Checklist score [MD =-2.64,95% CI:(-14.29,9.00),P = 0.66].Conclusion: Vitamin D treatment improves irritability symptoms in children with ASD,but limited by the number and quality of included studies,the above conclusions still need to be verified by more high-quality studies.