Correlation Of Fat-soluble Vitamin D And K Levels With Autism Spectrum Disorder In Children

Objective:To investigate the nutritional status of fat-soluble vitamin D（VD）and vitamin K（VK）in the serum of children with autism spectrum disorder（ASD）,and evaluate their relationship between the severity of ASD clinical symptoms and neuropsychological development,and to provide new clinical treatment ideas for children with ASD.Methods:131 children aged 18-72 months who were diagnosed with ASD at the Psychological and Behavioral Department of Jiangxi Children’s Hospital from January 2021 to February 2023 were selected as the ASD group,and 200 healthy children who were matched in age and gender during the same period were selected as the control group.The serum 25（OH）D levels of the enrolled children were detected using liquid chromatography tandem mass spectrometry,and vitamin K₁and K₂levels were detected using high-performance liquid chromatography,simultaneously using the Childhood Autism Rating Scale（CARS）and Gesell Developmental Scale（GDS）to assess the severity of clinical symptoms and the level of neuropsychological development in children with ASD.Results:1.A total of 331 children were included in the study,of which 131 were in the ASD group,including 102 boys（69.5%）and 29 girls（22.1%）,aged 40.00（28.00-50.00）months.There were 200 normal control children in the group,with 142boys（71.0%）and 58 girls（29.0%）,aged 38.00（27.00-54.00）months;There were no statistically significant differences between the two groups of children in terms of enrollment season,age,gender,gestational age,fetal birth weight,birth length,and age of mother during pregnancy（P>0.05）.In terms of birth order,the proportion of non-first fetus among children in the ASD group was higher than that in the healthy group（P<0.001）,and the educational level of the mother of ASD children was lower than that of the control group,the difference between groups was statistically significant（P<0.001）.2.The median level of 25（OH）D in the ASD group was lower than that in the control group（24.10ng/ml vs 30.60ng/ml）,while the vitamin K₁level in the ASD group was lower than that in the control group（0.48ng/ml vs 0.88ng/ml）;The median level of vitamin K₂in the ASD group was lower than that in the control group（0.14ng/ml vs 0.18ng/ml）,the differences between groups were statistically significant（P<0.01,P<0.01,P=0.033）;In the winter and spring seasons,the levels of vitamin K₁in the ASD children were lower than those in the control group,and there was a statistically significant difference between the groups（P=0.008）;In the summer and autumn seasons,the levels of 25（OH）D,vitamin K₁,and vitamin K₂in the ASD group were significantly lower than those in the control group（P<0.001,P<0.001,P=0.005）;Among boys,the levels of 25（OH）D,vitamin K₁,and K₂in the ASD group were lower than healthy children,with statistically significant differences between the groups（P<0.001,P<0.001,P=0.029）;Among girls,the levels of 25（OH）D with ASD were lower than those in the control group,with a statistically significant difference（P=0.008）;In the low age group,the serum levels of 25（OH）D and vitamin K₁in the ASD group were lower,with statistically significant differences between the two groups（P<0.01）;In the elderly group,the levels of serum 25（OH）D,vitamin K₁,and K₂in the ASD group were lower than those in the control group,the differences were statistically significant（P=0.023,P=0.020,P=0.027）.3.According to the CARS score,ASD children were divided into mild to moderate and severe levels.The serum 25（OH）D levels in severe children were lower than those in mild to moderate children（22.05ng/ml vs 26.70ng/ml）,and the difference was statistically significant（P=0.002）;The proportion of 25（OH）D deficiency and insufficiency in children with different severity was statistically significant（P<0.001）,while the proportion of vitamin K deficiency,sufficiency and excess was not statistically significant（P=0.780,P=0.524）;Correlation analysis was conducted between the levels of 25（OH）D,vitamin K₁,and vitamin K₂in the ASD group and the severity of clinical symptoms.25（OH）D was negatively correlated of the severity of clinical symptoms（r=-0.404,P<0.001）;There was no significant relation between vitamin K₁,vitamin K₂and severity（r=0.055,P=0.529;r=0.060,P=0.490）.4.According to Gesell’s assessment of adaptive DQ score<76,it is classified as dysplasia.89.06%of children in ASD group have different degrees of growth retardation;Correlation analysis was conducted between the levels of 25（OH）D,vitamin K₁,and vitamin K₂in the ASD group and different functional areas of neuropsychological development DQ.There was a weak positive correlation between the levels of 25（OH）D and DQ scores of adaptability,large motor,fine motor,language,and social development（r=0.275、0.300、0.244、0.380、0.368,all P<0.05）,and a weak negative correlation between vitamin K₂and DQ scores of adaptability and social development（r=-0.184,P=0.035;r=-0.182,P=0.038）There was no significant correlation between fine motor and language DQ scores（both P>0.05）;There was no significant correlation between vitamin K₁and scores in various functional areas of neuropsychological development（all P>0.05）.Conclusion:1.The levels of serum 25（OH）D,vitamin K₁and vitamin K₂in children with ASD were lower than those in normal children on average,so the supplementation of vitamin D and vitamin K should be paid attention to especially in children with ASD;2.The level of serum 25（OH）D in children with ASD was negatively correlated between the severity of clinical symptoms;3.Most children with ASD have poor development level.The serum 25（OH）D level is positively correlated with the DQ scores of the five energy regions of the neural development level,and the vitamin K₂level is weakly negatively correlated with the adaptive DQ and personal social DQ in the neural development.