| Objective:To investigate the levels of serum 25-hydroxyvitamin D in children with autism spectrum disorder(ASD),and to explore whether there is the relationship between ASD and serum Vit D levels in children in Jiangxi Province and whether there is difference between the north and the South.Methods:In this 1:1 matched case control study,200 children(1-6 years old)with ASD as case group or ASD group and 200 healthy children matched age and gender as control group were recruited from the Pediatric Neurology Clinic of Jiangxi Provincial Children's Hospital from January 2018 to December 2019.Serum levels of25OHD were detected by Electro-chemiluminescence immunoassay,and CARS,ABC,CABS,GDQ were evaluated for case group.The serum levels of 25OHD of children in the two groups were analyzed and those in ASD group were compared with the data of the north in literatures.The correlation between the scores of CARS,ABC,CABS,and GDQ of children in ASD group,and the levels of 25OHD were analyzed.Results:1.The level of serum 25OHD was 61.00±14.42nmol/L in ASD group,lower than 74.08±15.86nmol/L in control group(t=-8.63,P=0.00).The constituent ratios of 25OHD deficiency and 25OHD insufficiency in ASD group were 24.50%and 60.50%,higher than 4.50%and 43.50%in control group(?~2=74.01,P<0.01).The serum levels of 25OHD were 61.03±15.68nmol/L and 60.96±12.42nmol/L in1-3-years-old group and 3-6-years-old group,respectively,lower than76.89±16.86nmol/L and 69.95±13.32nmol/L in control group(t=-7.53,-4.50,P<0.01,respectively).The serum levels of 25OHD were 58.50±13.69nmol/L among ASD cases enrolled in seasons of spring and winter and 64.59±14.76nmol/L in seasons of summer and autumn,respectively,lower than 72.83±16.75nmol/L and75.88±14.38nmol/L in control group(t=-7.20,-4.86,P<0.01,respectively).The serum levels of 25OHD were 60.24±14.30nmol/L and 61.65±14.55nmol/L amongst ASD cases enrolled in birth seasons of spring and winter,respectively,lower than74.15±15.95nmol/L and 74.02±15.85nmol in control group(t=-6.27,-5.94,P<0.01,respectively).The serum levels of 25OHDwere 60.24±14.301nmol/L and61.65±14.554nmol/L in the rural and urban ASD groups,respectively,lower than74.15±15.95nmol/L and 74.02±15.85nmol/L in control group(t=-6.27,-5.94,P<0.01,respectively).2.The serum level of 25OHD was 59.82±14.65nmol/L in ASD boys,lower than65.88±12.45nmol/L in ASD girls(t=-2.38,P=0.02).The serum level of 25OHD was 58.50±13.69nmol/L in ASD cases enrolled in seasons of spring and winter,lower than 64.60±14.76nmol/L in seasons of summer and autumn(t=-3.00,P<0.01).The level of serum 25OHD was 62.24±14.64nmol/L in mild to moderate ASD group,higher than 57.30±13.21nmol/L in severe ASD group,(t=2.12,P=0.04).However,there was no significant difference in serum 25OHD level among ASD children in different birth seasons,ages,urban and rural areas,geographical distribution(P>0.05).3.There was slightly negative correlations between serum 25OHD levels and CARS scores(r=-0.15,P=0.03).But there were no significant correlations among ABC scores and CABS scores,and serum 25-OHD levels(r=-0.12,-0.10,P>0.05,respectively).The CARS scores,ABC scores,CABS scores were 35.17±4.26,65.21±13.84 and 17.94±6.03 in 25OHD<55nmol/L group,respectively,higher than33.98±4.22,61.22±11.46 and 16.30±5.30 in 25OHD?55nmol/L group(t=1.97,2.23 and 2.04,P=0.05,0.03 and 0.04,respectively).4.Gross motor dimension(71.83±18.60),fine motor dimension(62.31±18.61),language dimension(36.17±14.96),personal social dimension(52.33±19.584)and adaptive behaviour dimension(56.16±14.644)of Gessel Developmental Qotient(GDQ)in ASD group,respectively,were lower than 86.85±11.51,81.59±11.03,73.38±14.14,83.31±111.46 and 81.30±9.10 in control group(t=-8.60,-11.31,-22.77,-17.36 and-18.48,P<0.01,respectively).Gross motor dimension(75.07±16.79),fine motor dimension(67.36±17.51),personal social dimension(55.33±18.57)and adaptive behaviour dimension(59.33±12.88)in the1-3-year-olds group,respectively,were higher than 66.28±20.31,53.65±17.32,47.85±19.48 and 50.72±15.95 in the 3-6-years-old group(t=2.98?4.86?2.44 and3.56,P<0.01?<0.01?0.02?and<0.01,respectively).5.There was weakly negative correlations between the serum 25OHD levels and language dimension scores of GDQ(r=0.20,P=0.01).However there were no significant correlations between serum 25-OHD levels and large motor,fine motor,language,personal social and adaptive behaviour dimensions scores(r=0.01,0.02,0.05 and 0.08,P=0.94,0.81,0.53 and 0.33,respectively).Language dimension in25OHD<55nmol/L group were 33.08±13.16,lower than 38.54±15.89 in 25OHD?55nmol/L group(t=2.40,P=0.02),but there were no significance between the two groups in the large motor,fine motor,personal social and adaptive behaviour dimensions(t=1.17,0.49,-0.19 and-0.12,P>0.05,respectively).Conclusion:1.The serum level of 25OHD and the ratio of 25OHD deficiency and 25OHD insufficiency in ASD children were significantly lower than those in healthy children,and the serum 25OHD levels of ASD in different ages,seasons and urban and rural distribution were markly lower than those of healthy children,which suggested that the level of serum 25OHD in children with ASD was an important risk factor for ASD.2.The serum level of 25OHD of ASD in boys were lower than that in girls,and that of ASD enrolled in seasons of winter and spring was aksi lower than that in seasons of summer and autumn.It indicated that the key population of therapeutic intervention with Vit D should be male children in winter and spring.3.There was slightly negative correlations between serum 25OHD levels and CARS scores.The lower the serum level of 25OHD,the higher the scores of CARS,ABC and CABS.It showed that there was the dose effect relationship between serum25OHD levels and ASD core symptoms.4.There was weakly positive correlations between the serum level of 25OHD and language dimension in GDQ.The older they grew,the lower GDQ was,which imply that early diagnosis and early intervention of ASD was of importance. |
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