关键词: 抽动障碍, 维生素D, 儿童, 临床亚型, 严重程度

Abstract: Objective To explore the association of vitamin D(VD) level with tic disorder (TD) symptom severity and clinical classification, in order to provide evidence for comprehensive diagnosis and treatment of TD. Methods From March 2020 to November 2020, a total of 225 TD children (TD group) and 228 healthy children (control group) in Shanghai Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine, were retrospectively enrolled in this study. According to the Yale Global Tic Severity Scale (YGTSS), children in the TD group were divided into mild TD group (≤25 points)and moderate to severe TD group(＞25 points). According to the DSM-Ⅴ clinical classification standard, children with TD were divided into provisional tic disorder group (PTD group), chronic tic disorder group (CTD group) and Tourette syndrome group (TS group). The correlation between vitamin D deficiency and the development of TD was analyzed. Results Serum VD level of children in TD group was significantly lower than that of the control group[(22.18±6.29) ng/ml,(26.14±6.48) ng/ml, t=6.60,P<0.001], and the proportion of insufficient or lacking VD (89.8%) was high in the control group (75.9%) (χ²=15.35, P<0.001). Serum VD level of the moderate to severe TD group was lower than that of the mild TD group and the control group (F=23.85, P<0.001). Serum VD level of TD children was negatively related to the severity of symptoms (r=-0.215, P=0.001). The difference in VD levels among three clinical subtypes of TD and the control group was statistically significant (F=16.93, P<0.001). Among them, the CTD group had the lowest VD level, which was significantly lower than the control group.The proportion of insufficient or lack of serum VDin children with TD subtypeswas higher than that of the control group (χ²=15.91, P<0.001). Conclusions VD deficiency is more common in children with TD. There is a certain correlation between the degree of VD deficiency and the severity of tic disorder symptoms and clinical subtypesin children with TD. The detection of vitamin D level can be used as an auxiliary examination for children with TD, providing new clinical ideas for the treatment of TD.

Key words: tic disorder, vitamin D, children, clinical subtypes, severity