The Level And Clinical Significance Of Fat-soluble Vitamins In Serum Of Children With Autism Spectrum Disorder

ObjectivesTo investigate the relationship between the levels of serum fat-soluble vitamins A,D and E and the severity of ASD symptoms in children with autism spectrum disorder（ASD）,and to provide a theoretical basis for the comprehensive prevention and treatment of ASD.Methods1.121 children who were diagnosed with ASD at the Children’s Health Care Department of the Affiliated Hospital of Qingdao University or other special training institutions from 09/2019 to 09/2020 were selected as the ASD group.According to the Childhood Autism Rating Scale（CARS）scores,the mild-moderate ASD group（n₁=75）and the severe ASD group（n₂=46）were divided.Children with normal development who visited the Child Health Department of Qingdao University Hospital for routine physical examination and 135 children recruited from three kindergartens and elementary school in Qingdao were used as the control group.2.Children who met the diagnostic criteria of ASD in DSM-V were evaluated on site by professional child health care physicians and filled out CARS,and children in both groups filled out the basic child profile questionnaire.At least 3 ml of fasting elbow venous blood was collected in the early morning for the determination of VA,VD and VE levels in both groups.Differences in fat-soluble vitamin levels between the two groups were compared to clarify whether there were differences in fat-soluble vitamins between children with ASD with different severity of symptoms.P<0.05indicates that the difference is statistically significant.Results1.The serum VD level of children in the ASD group was（23.69±10.09）ng/ml and the VD level in the control group was（24.92±7.84）ng/ml.The difference in VD levels between the two groups was statistically significant（t=-1.10,P=0.003）.The differences in VA and VE levels between the two groups were not statistically significant（P>0.05）.41.32%（50/121）and 25.19%（34/135）of the children in the ASD and control groups had VD deficiency or insufficiency,respectively,and the differences in VD deficiency or insufficiency between the two groups were statistically significant（χ²=27.54,P=0.008）,and the differences in VA and VE deficiency or insufficiency between the two groups was not statistically significant（P>0.05）.2.According to the CARS score,children in the ASD group were divided into the mild-moderate ASD group and the severe ASD group,in which there was no statistical difference in the VA and VE levels and the proportion of children with deficiency or deficiency in each group（P>0.05）.The VD levels of children in the severe ASD group were lower than those in the control group,and the differences were statistically significant（P<0.05）,and the results of the differences in VD levels between children in the mild-moderate ASD group and those in the control and severe ASD groups were not statistically significant（P>0.05）;the results of the differences in the proportion of children with insufficient or deficient VD in each group were statistically significant(χ²⁼13.25,P=0.001).The results of the differences in VA and VE levels and the proportion of deficient or lacking in each group were not statistically significant（P>0.05）.3.Pearson’s correlation analysis between serum VA,VD and VE levels and CARS severity scores in children with ASD showed that VD levels were negatively correlated with ASD severity,and the results were statistically significant（r=-0.294,P=0.001）;VA and VE levels did not show a clear correlation with the severity of ASD（P>0.05）.4.Logistic regression analysis was performed using whether the child was a child with ASD as the dependent variable,and factors with statistically significant differences between the two groups were included in the independent variables.The results showed that the mother’s job as a manager/cadre/professional/businessman（OR=0.19,95%CI=0.07～0.47）,no history of psychiatric genetic disorders in family members（OR=0.03,95%CI=0.003～0.37）,maternal emotional stability during pregnancy（OR=0.46,95%CI=0.22～0.96）,and the absence of severe picky eating in children was a protective factor（OR=0.14,95%CI=0.06～0.31）;the absence of VA,VD or VE alone during pregnancy（OR=4.32,95%CI=1.32～14.09）and the absence of multivitamin during pregnancy（OR=4.99,95%CI=2.18～11.42）were risk factors.Conclusion1.The VD levels of children with ASD were lower than those of normal children,and the proportion of VD deficiency or deficiency was higher than that of control children.The VD levels of children with severe ASD were lower than those of normal children,and the proportion of deficiency or lack of VD was even higher.2.The serum VD level of children with ASD was negatively correlated with the severity of ASD symptoms.3.No history of psychiatric genetic diseases in family members,mother’s emotional stability during pregnancy,and no serious picky eating in children were protective factors for ASD;mother’s not taking simple VA,VD,VE or multivitamin during pregnancy were risk factors for ASD.