Principles of monitoring and intervention for micronutrient deficiency in children with autism spectrum disorder

doi:10.11852/zgetbjzz2020-1787

Abstract

Abstract: Autism spectrum disorder (ASD) is a common and complex neurodevelopmental disorder for which there is no specific treatment and the clinical practice is mainly based on behavioral interventions,causing a huge economic burden to the families and society.The etiology of ASD is unclear and is recognized as the result of interaction of a complex genetic background with environmental risk factors,resulting in different clinical manifestations of children with ASD.Current evidence suggests that malnutrition,especially micronutrient deficiencies in utero and in early postnatal period,may be associated with the onset and clinical manifestations of ASD.These measures,including ensuring sufficient micronutrients during pregnancy,strengthening micronutrient monitoring for ASD children,and timely and reasonable intervention,may reduce the incidence of ASD and improve the behaviors of children with ASD to some extent.

Key words: autism spectrum disorder, micronutrient, neurodevelopmental disorder

摘要： 孤独症谱系障碍(ASD)是常见的复杂神经发育障碍疾病,尚无特效治疗,临床主要以行为干预为主,给患者家庭和社会造成了巨大的经济负担。ASD病因不清,公认是复杂遗传背景与环境危险因素相互作用的结果,从而导致ASD患者临床表现各异。目前的证据表明,营养不良,尤其是宫内及生后早期的微营养素不足可能与ASD的发病及临床表现存在一定关联。保证孕期微营养素充足,加强对ASD儿童进行微营养素监测,及时合理地进行干预,在一定程度上可能减少ASD的发病及改善ASD儿童的行为。

关键词: 孤独症谱系障碍, 微营养素, 神经发育障碍性疾病

CLC Number:

R749.94

LI Ting-yu, TAN Mei. Principles of monitoring and intervention for micronutrient deficiency in children with autism spectrum disorder[J]. journal1, 2021, 29(1): 1-4.

李廷玉, 谭梅. 孤独症谱系障碍儿童微营养素缺乏的监测和干预原则[J]. 中国儿童保健杂志, 2021, 29(1): 1-4.

References

[1] Roth C,Magnus P,Schjolberg S,et al.Folic acid supplements in pregnancy and severe language delay in children[J].JAMA,2011,306(14):1566-1573.
[2] Veena SR,Murray-Kolb LE,Khatry SK,et al.Higher maternal plasma folate but not vitamin B12 concentrations during pregnancy are associated with better cognitive function scores in 9- to 10- year-old children in South India[J].J Nutr,2010,140(5):1014-1022.
[3] Suren P,Roth C,Bresnahan M,et al.Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children[J].JAMA,2013,309(6):570-577.
[4] Schmidt RJ,Tancredi DJ,Ozonoff S,et al.Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE(Childhood Autism Risks from Genetics and Environment) case-control study[J].Am J Clin Nutr,2012,96(1):80-89.
[5] Bjork M,Riedel B,Spigset O,et al.Association of folic acid supplementation during pregnancy with the risk of autistic traits in children exposed to antiepileptic drugs in utero[J].JAMA Neurol,2018,75(2):160-168.
[6] Smolka V,Bekarek V,Hlidkova E,et al.Metabolic complications and neurologic manifestations of vitamin B12 deficiency in children of vegetarian mothers[J].Cas Lek Cesk,2001,140(23):732-735.
[7] Magnusson C,Lundberg M,Lee BK,et al.Maternal vitamin D deficiency and the risk of autism spectrum disorders:population-based study[J].BJ Psych Open,2016,2(2):170-172.
[8] Chen YH,Fu L,Hao JH,et al.Maternal vitamin D deficiency during pregnancy elevates the risks of small for gestational age and low birth weight infants in Chinese population[J].J Clin Endocrinol Metab,2015,100(5):1912-1919.
[9] Vinkhuyzen AAE,Eyles DW,Burne TH,et al.Prevalence and predictors of vitamin D deficiency based on maternal mid-gestation and neonatal cord bloods:the generation R study[J].J Steroid Biochem Mol Biol,2016,164:161-167.
[10] Schmidt RJ,Tancredi DJ,Krakowiak P,et al.Maternal intake of supplemental iron and risk of autism spectrum disorder[J].Am J Epidemiol,2014,180(9):890-900.
[11] Levine SZ,Kodesh A,Viktorin A,et al.Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring[J].JAMA Psychiatry,2018,75(2):176-184.
[12] Xu X,Li C,Gao X,et al.Excessive UBE3A dosage impairs retinoic acid signaling and synaptic plasticity in autism spectrum disorders[J].Cell Res,2018,28(1):48-68.
[13] Hao Z,Wu Q,Li Z,et al.Maternal exposure to triclosan constitutes a yet unrecognized risk factor for autism spectrum disorders[J].Cell Res,2019,29(10):866-869.
[14] Megson MN.Is autism a G-alpha protein defect reversible with natural vitamin A?[J].Med Hypotheses,2000,54(6):979-983.
[15] Guo M,Zhu J,Yang T,et al.Vitamin A and vitamin D deficiencies exacerbate symptoms in children with autism spectrum disorders[J].Nutr Neurosci,2019:22(9):637-647.
[16] Guo M,Zhu J,Yang T,et al.Vitamin A improves the symptoms of autism spectrum disorders and decreases 5-hydroxytryptamine(5-HT):a pilot study[J].Brain Res Bull,2018,137:35-40.
[17] Wang T,Shan L,Du L,et al.Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder:a systematic review and meta-analysis[J].Eur Child Adolesc Psychiatry,2016,25(4):341-50.
[18] Mostafa GA,Ayadhi LYA.Reduced serum concentrations of 25-hydroxy vitamin D in children with autism:relation to autoimmunity[J].J Neuroinflammation,2012,9:201.
[19] Cannell JJ.Autism,will vitamin D treat core symptoms? Med Hypotheses,2013,81(2):195-198.
[20] Jia F,Wang B,Shan L,et al.Core symptoms of autism improved after vitamin D supplementation[J].Pediatrics,2015,135(1):196-198.
[21] Pivina L,Semenova Y,Dosa M D,et al.Iron deficiency,cognitive functions,and neurobehavioral disorders in children[J].J Mol Neurosci,2019,68(1):1-10.
[22] Gunes S,Ekinci O,Celik T.Iron deficiency parameters in autism spectrum disorder:clinical correlates and associated factors[J].Ital J Pediatr,2017,43(1):86.
[23] Herguner S,Kelesoglu FM,Tanidir C,et al.Ferritin and iron levels in children with autistic disorder[J].Eur J Pediatr,2012,171(1):143-146.
[24] Bener A,Khattab AO,Bhugra D,et al.Iron and vitamin D levels among autism spectrum disorders children[J].Ann Afr Med,2017,16(4):186-191.
[25] Zhang Y,Hodgson NW,Trivedi MS,et al.Decreased brain levels of vitamin B12 in aging,autism and schizophrenia[J].PLoS One,2016,11(1):0146797.
[26] Alfawaz H,Al-Onazi M,Bukhari SI,et al.The independent and combined effects of omega-3 and vitamin B12 in ameliorating propionic acid Induced biochemical features in juvenile rats as rodent model of autism[J].J Mol Neurosci,2018,66(3):403-413.
[27] Al-Farsi YM,Waly MI,Deth RC,et al.Low folate and vitamin B12 nourishment is common in omani children with newly diagnosed autism[J].Nutrition,2013,29(3):537-541.
[28] Frye RE,Melnyk S,Fuchs G,et al.Effectiveness of methylcobalamin and folinic Acid treatment on adaptive behavior in children with autistic disorder is related to glutathione redox status[J].Autism Res Treat,2013,2013:609705.
[29] Frye RE,Delatorre R,Taylor H,et al.Redox metabolism abnormalities in autistic children associated with mitochondrial disease[J].Transl Psychiatry,2013,3:e273.